Prognostic Significance of Preoperative Anemia in Patients Undergoing Surgery for Renal Cell Carcinoma: A Meta-analysis

Abstract

Aim: To better evaluate the association between preoperative anemia and outcomes in patients following radical or partial nephrectomy for renal cell carcinoma (RCC).

Materials and methods: A meta-analysis of hazard ratios (HR) was conducted to measure the association between preoperative anemia and all-cause mortality (ACM), cancer-specific mortality (CSM), and disease recurrence (DR) in patients who underwent surgery for RCC.

Results: A total of 14 studies (8,673 patients) met the eligibility criteria. All studies reported survival outcomes using the multivariable Cox proportional hazards model. Pooled results showed that preoperative anemia was associated with increased ACM [HR=2.13, 95% Confidence Interval (CI)=1.48-3.06], CSM (HR=1.91, 95% CI=1.26-2.90), and DR (HR=1.67, 95% CI=1.16-2.40).

Conclusion: This meta-analysis indicates that preoperative anemia appears to be associated with earlier recurrence and shorter survival of patients undergoing radical or partial nephrectomy for RCC. Our findings, however, still need to be validated by well-designed prospective studies with larger sample sizes and well-controlled confounding factors.

Keywords: Renal cell carcinoma; anemia; hemoglobin; meta-analysis; mortality.