Abstract
The relationship between ABO blood groups (BG) and risk of incidence in cancers including gynecological cancers has been widely studied, showing increased incidence risk for BG A patients. As available data are inconsistent we investigated whether BG and their anti-glycan antibodies (anti-A and anti-B) have prognostic values in gynecological cancers. We retrospectively evaluated 974 patients with gynecological cancers in three cancer centers (Switzerland and Australia) between 1974 and 2014 regarding the relationships between clinico-pathological findings and the BG. Time to disease recurrence was significantly influenced by BG in patients with ovarian (n = 282) and vulvar (n = 67) cancer. BG O or B patients showed a significantly increased risk for ovarian cancer relapse compared to A, 59% and 82%, respectively (p = 0.045; HR O vs A = 1.59 (CI 1.01–2.51) and (p = 0.036; HR A vs B = 0.55 (CI 0.32–0.96). Median time to relapse for advanced stage (n = 126) ovarian cancer patients was 18.2 months for BG O and 32.2 for A (p = 0.031; HR O vs A = 2.07 (CI 1.07–4.02)). BG also significantly influenced relapse-free survival in patients with vulvar cancer (p = 0.002), with BG O tending to have increased relapse risk compared to A (p = 0.089). Blood groups hence associate with recurrence in ovarian and vulvar cancer: women with BG O seem to have a lower ovarian cancer incidence, however are more likely to relapse earlier. The significance of the BG status as a prognostic value is evident and may be helpful to oncologists in prognosticating disease outcome and selecting the appropriate therapy.
Highlights
The ABO blood group (BG) in humans is the most important BG system in transfusion and transplantation medicine
BG O and B ovarian cancer patients had a considerably increased risk for recurrence compared to BG A patients (i.e. BG A patients have a marked better prognosis with a longer time-to-relapse than BG O and B patients) and BG A vulvar cancer patients at least tend to have a longer time-to-relapse than patients with BG O
Our data indicate that relapse-free survival (RFS) in Ovarian cancer (OC) and vulvar cancer (VC) patients is associated with the ABO blood type, suggesting that the ABO status is an important factor for RFS
Summary
The ABO blood group (BG) in humans is the most important BG system in transfusion and transplantation medicine. A and B allele, resulting in two different glycosyltransferase activities These activities add either N-acetylgalactosamine or galactose to the precursor H antigen to form A or B antigen, respectively. The absence of both antigens in BG O owes to a frameshift mutation at the N-terminus of the enzyme [1]. ABO BG antigens are commonly expressed on cell surface glycosphingolipids or glycoproteins present on erythrocytes and on a variety of other human cells and tissues (e.g. gastro-intestinal, bronchopulmonary, skin and urogenital epithelial cells [2]), and occur in various body fluids and secretions [3]
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