e15123 Background: The aim of this retrospective study was to assess whether the pre-chemotherapy hemoglobin (Hb) levels have any impact on the clinical outcome of patients with advanced urothelial carcinoma who received a first-line GP-based regimen. Methods: A total of 181 evaluable patients with recurrent locally advanced or metastatic urothelial carcinoma received GP between 2001 and 2009 in a single institution. The relationship of pretreatment variables including Hb levels and response was evaluated with logistic regression, and prognostic factors for survival were analyzed with Cox's multivariate model. All the patients had ECOG performance status 0-2 at presentation. Results: The overall median survival was 42.8 months (95% CI: 34.13-51.53) with a 21.0% censoring rate at a follow-up time 71.7 months (range, 15.9-157.4 months). Response was achieved in 74.6% of the patients with a complete response rate of 17.1%. Gross hematuria, disease status before palliative first line GP chemotherapy (metastasis vs locally advanced status) were independent prognostic variables for overall survival. Conversely, albumin levels (<3.5 versus ≥3.5) and Hb levels (<12.1 g/dl versus ≥12.1) were inversely related to overall survival at multivariated analysis. Conclusions: This investigation showed that Hb levels before starting first-line GP-based chemotherapy is an independent prognostic factor for overall survival in patients with advanced urothelial carcinoma. No significant financial relationships to disclose.