Hemoglobin Level as a Prognostic Factor for Locally Advanced Bladder Cancer Patients Treated with Radical Radiotherapy

Abstract

Anemia is a common symptom in cancer patients and usually associated with poor prognosis. Urinary bladder cancer (BC) is the most common cancer in the urological tract with anemia being one the most common presenting symptom. Radical radiotherapy is the treatment of choice for advancer disease with many factors could influence the prognosis. Aim: To identify pre-treatment hemoglobin level as prognostic factor for advanced bladder cancer treated with radiotherapy. Materials and Methods: A retrospective study reviewed the data of 88 patients with advanced bladder cancer, treated with radical radiotherapy from 2013 to 2018. Results: Median follow-up was 45 months. The median PFS was 26.87 months but when comparing anemic to non–anemic patient there was significant difference (17.25 and 40.02 months) respectively. Also as regards overall survival the median was 28.98 months but 20.24 and 40.47 months in anemic and non-anemic patients respectively with significant difference. Local or distant progression detected in 36 out of 50 anemic patients compared to only 4 out of 38 non-anemic patients. In multivariate analysis anemia was proved to be the strongest predictor of mortality. Conclusion: Pre-treatment Hb level is an important factor affecting the prognosis of advanced bladder cancer patients treated with radical radiotherapy. Low HB level could be considered as a good biological marker for aggressive disease.