The impact of preoperative anemia on oncologic outcome in patients undergoing radical cystectomy for urothelial carcinoma of the bladder

To investigate the impact of preoperative anemia (PA) on oncologic outcomes among patients who underwent radical cystectomy (RC) for bladder cancer. We reviewed the records of 200 patients undergoing RC between October 2003 and December 2014. Patients were categorized according to PA status. We performed multivariable Cox regression analyses to assess the impact of PA on oncological outcomes. Among 200 patients, 81 patients (40.5 %) had PA according to definition of the WHO classification. Fifty-two (26 %) of 200, 12 (6 %) of 200 and 61 (30.5 %) of 200 patients experienced the disease recurrence (DR), cancer-specific mortality (CSM) and all-cause mortality (ACM), respectively. In Kaplan-Meier analysis, the non-PA group showed a significantly higher 5-year DR-free survival than PA group (log-rank test: p = 0.018). The non-PA group showed a similar pattern of CSM and ACM (p = 0.004 and p = 0.037, respectively). In multivariable Cox proportional hazards analysis, PA was significantly associated with DR (HR 1.86, 95 % CI, p = 0.04) and ACM (HR 2.13, 95 % CI, p = 0.006) after adjusting other factors. The preoperative anemic bladder cancer patients who underwent RC had worse oncological outcomes than non-anemic bladder cancer patients.