Objective: To assess the impact of pretreatment hemoglobin (Hb) and body mass index (BMI) on overall survival (OS) following radical cystectomy (RC) for bladder cancer (BCa) in males versus females. Materials and Methods: We retrospectively reviewed 152 patients treated with RC for BCa between 2012 and 2016. Hb was categorized as low Hb or high Hb. BMI was classified as underweight, overweight, or obese. Univariate and multivariate Cox regression models were used to evaluate the association of Hb and BMI with OS both in the entire cohort and in gender subgroups. Results: In these 152 BCa cases, 79 cases (52.0%) were categorized as low Hb, and 67 cases (44.1%) were overweight or obese. Both Hb (p = 0.001) and BMI (p = 0.046) were independent prognostic factors for the entire cohort. In females, only Hb (p = 0.012) and BMI (p = 0.027) were significant prognostic factors. In males, Hb (p = 0.024) was an independent prognostic factor, but BMI (p = 0.142) lost significance in multivariate analysis. Conclusion: Our results found that both higher pretreatment Hb and higher BMI were associated with favorable prognosis for OS in BCa treated with RC. The differing impact of Hb and BMI on prognosis in progression of BCa in males versus females suggests there is involvement of sex hormone pathways.

Keywords:
Bladder cancer, Cystectomy, Hemoglobin, Body mass index, Sex hormone, Prognosis
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2019
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