Login to Access Video or Poster Abstract: MP21-16
Sources of Funding: None.

Introduction

Venous thromboembolism (VTE) is a serious complication following radical cystectomy (RC). Several risk factors have been identified including high BMI, immobility and advanced cancer. Hematologic studies have recently found ABO blood type as a genetic risk factor for VTE. We attempted to elucidate the relationship between ABO blood type and risk of VTE post RC.

Methods

1409 patients with urothelial bladder cancer who underwent RC (intent-to-cure) between 2003 and 2015 were identified. All these patients received VTE prophylaxis that included oral Coumadin (2003-2009), subcutaneous heparin (2009-2015), and post-discharge 4-week lovenox (2013-2015). 1341 patients had their blood type available. VTE including DVT and PE within 90 days of surgery were recorded. We evaluated the association of blood type with risk of postoperative VTE using logistic regression model.

Results

A total of 595 (44.4%) patients were blood type O and 746 (55.6%) were non-O (A, B and AB). 1063 (79.3%) patients were male. 191 (14.2%) patients received adjuvant while 257 (19.2%) received neoadjuvant chemotherapy. 905 patients received an orthotopic urinary diversion (67.4%). No significant differences were noted between those with O vs. non-O blood type regarding patient age (median 70 yrs vs. 70, P=0.2), BMI (median 27.4 vs. 26.9, P=0.3), Charlson comorbidity index (P=0.7), hospital stay following RC (median 8 days vs. 8, P=0.6), tumor stage (organ confined (OC) vs. extravesicular (EV)) (65.3% vs. 61.7% OC) (P=0.5) or pN+ status (21.8% vs. 23.2%, P=0.5). Venous thromboembolic events within 90 days of surgery were recorded in 90 patients (6.7%) (43% DVT-only, 57% PE+/- DVT). On multivariate analysis controlling for age, BMI, neoadjuvant chemotherapy, and pathologic stage, non-O blood type was associated with a nearly two-fold increased risk of VTE (odds ratio [OR] = 1.94, 95% CI: 1.215-3.098, P=0.004). No significant difference was observed in the rates of VTE between the 3 prophylactic eras.

Conclusions

Non-O blood type was found to be independently associated with a significantly increased risk of VTE among patients undergoing radical cystectomy. Patients with non-O blood type may benefit from counseling and more comprehensive perioperative prophylaxis. _x000D_

Funding

None.