Background: Hemoglobin (Hb) has been identified to be an independent prognostic marker for oncological outcomes in several malignancies. However, the impact of Hb levels before radical prostatectomy (RP) in localized prostate cancer remains unclear.Methods: Preoperative Hb levels were retrospectively collected from patients, who underwent RP from 2016 to 2022. Hb levels were analyzed as continuous and binary variables. For binary analysis, the cohort was divided into high-Hb (≥150 g/L) and low-Hb (<150 g/L) groups using the median as a cutoff. We used Spearman rank correlation to assess possible associations between Hb and continuous variables and logistic regression for Hb and binary variables. To assess the impact of preoperative Hb on recurrence-free survival (RFS), adjuvant treatment free survival (TFS), and metastasis-free survival (MFS), univariate and multivariate Cox regression analyses were performed.Results: A total of 567 patients were included in the analysis. Higher Hb levels, both when analyzed as a continuous variable and when divided in high and low groups, were inversely correlated with age (p< 0.001) and the International Society of Urological Pathology (ISUP) grade (p= 0.005 orp= 0.028, respectively). Patients in the high-Hb group showed a decreased risk of extraprostatic disease (≥pT3) (odds ratio [OR] 0.71, 95%-CI: 0.50–0.99,p= 0.047). In univariate cox regression analysis, high-Hb patients had a significantly longer RFS compared to the low-Hb group (hazard ratio [HR] 0.64, 95%-CI: 0.44–0.92,p= 0.015). When adjusting for age, ISUP grade, positive surgical margin, prostate specific antigen, nodal status, and ≥pT3, this effect was no longer statistically significant (HR 0.76, 95%-CI 0.56–1.22,p= 0.178). Hb was not a significant prognostic factor for TFS or MFS.Conclusions: In this large cohort, lower preoperative Hb values were associated with a more aggressive tumor grading and shorter RFS. However, we were unable to identify Hb as an independent predictor of oncological survival outcomes.
背景：血红蛋白（Hb）已被证实是多种恶性肿瘤预后的独立预测指标。然而，在局限性前列腺癌中，根治性前列腺切除术（RP）前的Hb水平对预后的影响尚不明确。方法：回顾性收集2016年至2022年间接受RP患者的术前Hb水平。将Hb作为连续变量和二分变量进行分析。在二分变量分析中，以中位数（150 g/L）为界，将队列分为高Hb组（≥150 g/L）和低Hb组（<150 g/L）。采用Spearman秩相关分析评估Hb与连续变量之间的潜在关联，使用逻辑回归分析Hb与二分变量之间的关系。为评估术前Hb对无复发生存期（RFS）、无辅助治疗生存期（TFS）和无转移生存期（MFS）的影响，进行了单因素和多因素Cox回归分析。结果：共纳入567例患者进行分析。无论作为连续变量还是高低分组分析，较高的Hb水平均与年龄（p<0.001）和国际泌尿病理学会（ISUP）分级呈负相关（分别为p=0.005和p=0.028）。高Hb组患者发生前列腺外疾病（≥pT3）的风险降低（比值比[OR] 0.71，95%置信区间：0.50–0.99，p=0.047）。单因素Cox回归分析显示，与低Hb组相比，高Hb组患者的RFS显著延长（风险比[HR] 0.64，95%置信区间：0.44–0.92，p=0.015）。但在调整年龄、ISUP分级、手术切缘阳性、前列腺特异性抗原、淋巴结状态及≥pT3等因素后，这种效应不再具有统计学显著性（HR 0.76，95%置信区间：0.56–1.22，p=0.178）。Hb并非TFS或MFS的显著预后因素。结论：在这个大型队列中，较低的术前Hb值与更具侵袭性的肿瘤分级和较短的RFS相关。然而，本研究未能证实Hb可作为肿瘤生存结局的独立预测因子。
肿瘤(癌症)患者之家