Milojevic, Bogomir (36990126400)Bogomir (36990126400)MilojevicDzamic, Zoran (6506981365)Zoran (6506981365)DzamicKajmakovic, Boris (56549005500)Boris (56549005500)KajmakovicDurutovic, Otas (6506011266)Otas (6506011266)DurutovicBumbasirevic, Uros (36990205400)Uros (36990205400)BumbasirevicSipetic Grujicic, Sandra (6701802171)Sandra (6701802171)Sipetic Grujicic2025-06-122025-06-122015https://doi.org/10.1016/j.clgc.2015.03.007https://www.scopus.com/inward/record.uri?eid=2-s2.0-84941599936&doi=10.1016%2fj.clgc.2015.03.007&partnerID=40&md5=76b0f1120e4f1ec5554b7e31449d5566https://remedy.med.bg.ac.rs/handle/123456789/8081Background: To investigate the prognostic impact of preoperative anemia on urothelial and extraurothelial recurrence after radical nephroureterectomy. Methods: A single-center series of 238 consecutive patients who were treated with radical nephroureterectomy for upper tract urothelial carcinoma was evaluated. We categorized patients on the basis of hemoglobin level into 2 groups, including normal or anemia. Survival was estimated using the Kaplan-Meier method. Cox proportional hazard regression models were used to evaluate the association of preoperative anemia with outcome, controlling for clinicopathologic variables. Results: Ninety-seven patients (40.8%) had anemia (median hemoglobin level, 143 vs. 107 g/L). Preoperative anemia was associated with history of bladder cancer (P =.01), tumor multifocality (P =.03), lymphovascular invasion (P =.05), and adjuvant chemotherapy (P =.01). Higher tumor stage and grade, and lymph node metastasis were significantly associated with preoperative anemia. Preoperative anemia was independently associated with extraurothelial recurrence (hazard ratio, 1.95; 95% confidence interval, 1.14-3.34; P =.01) in multivariate Cox regression analyses. Only a history of bladder tumor (hazard ratio, 2.07; P =.009) and tumor multifocality (hazard ratio, 3.97; 95% confidence interval, 2.37-6.67; P <.001) were independently associated with urothelial recurrence. The 5-year cancer-specific survival for patients with normal hemoglobin level was 82.1% and for patients with preoperative anemia was 54.2%. Conclusion: Patients with preoperative anemia had a greater probability of having upper tract urothelial carcinoma with higher tumor stages, higher tumor grades, and lymph node metastasis (pN+). Preoperative anemia was statistically significantly associated with worse cancer-specific survival and extraurothelial recurrence in patients who underwent radical nephroureterectomy. © 2015 Elsevier Inc. All rights reserved.AnemiaRadical nephroureterectomyRecurrenceSurvivalUpper urinary tract urothelial carcinoma