Abstract
To test the hypothesis of associations between the ABO blood group system (ABO-bg) and prostate cancer (PCa) features in the surgical specimen of patients treated with robot-assisted radical prostatectomy (RARP). Between January 2013 and October 2020, 1114 patients were treated with RARP. Associations of ABO-bg with specimen pathological features were evaluated by statistical methods. Overall, 305 patients were low risk (27.4%), 590 intermediate risk (50%) and 219 high risk (19.6%). Pelvic lymph node dissection was performed in 678 subjects (60.9%) of whom 79 (11.7%) had cancer invasion. In the surgical specimen, tumor extended beyond the capsule in 9.8% and invaded seminal vesicles in 11.8% of cases. Positive surgical margins (PSM) were detected in 271 cases (24.3%). The most frequently detected blood groups were A and O, which were equally distributed for both including 467 patients (41.9%), followed by groups B (127 cases; 11.4%) and AB (53 subjects; 4.8%). Among specimen factors, the ABO-bgs associated only with the risk of PSM, which was higher for blood group O (30.4%) compared with group A (19.5%) after adjusting for other standard clinical predictors (odds ratio, OR = 1.842; 95% CI 1.352–2.509; p < 0.0001). Along the ABO-bgs, the risk of PSM was increased by group O independently by other standard preoperative factors. The ABO-bgs may represent a further physical factor for clinical assessment of PCa patients, but confirmatory studies are required.
Highlights
Prostate cancer (PCa) is one of the most investigated cancers in the aging male who is likely to have the disease detected at early stages [1, 2]
Potential preoperative factors for stratifying prostate cancer (PCa) clinical risk classes could be represented by blood group antigens, which are polymorphic, inherited structural characters that are present on the outer surface of the red cell membrane and are located on proteins, glycoproteins or glycolipids; human blood group antigens have been associated with clinical disorders[3]
In a period ranging from January 2013 to October 2020, 1114 consecutive patients who underwent robot-assisted radical prostatectomy (RARP) were included after excluding cases who were under androgen blockade and/or had prior treatments for PCa
Summary
Prostate cancer (PCa) is one of the most investigated cancers in the aging male who is likely to have the disease detected at early stages [1, 2]. Clinical PCa includes a heterogeneous set of patients who are classified into risk categories by prognostic clinical factors including prostate-specific antigen (PSA), tumor stage, and grade, as well [1, 2]. Aggressive PCa biology may be detected in the surgical specimen after RARP; as such, further clinical factors are required to stratify risk categories [1, 2]. A retrospective study, which investigated a small heterogeneous cohort of PCa patients, has shown associations between high-risk PCa and ABO-bgs [12]. Another retrospective study showed that the ABO-bgs correlated with survival on PCa vaccine therapy [13]. The hypothesis of associations between ABO-bgs and PCa is an unsettled topic that needs more clinical investigations, which should be interpreted according to the complexity of clinical and pathological manifestations of PCa [14]
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