Gender-specific outcomes of bladder cancer patients: A stage-specific analysis in a contemporary, homogenous radical cystectomy cohort. Issue 3 (March 2015)

• Record Type: Journal Article
• Authors: Soave, A.; Dahlem, R.; Hansen, J.; Weisbach, L.; Minner, S.; Engel, O.; Kluth, L.A.; Chun, F.K.; Shariat, S.F.; Fisch, M.; Rink, M.
• Is Part Of: European journal of surgical oncology. Volume 41:Issue 3(2015:Mar.)
• Page Start: 368
• Page End: 377
• Publication Date: 2015-03
• Subjects: Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2014.03.003
• Languages: English
• ISSNs: 0748-7983

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Introduction</title> <p id="abspara0010">Controversial findings regarding gender-specific oncological outcomes of urothelial carcinoma of the bladder (UCB) have recently been reported. The aim of this study was to analyze gender-specific outcomes using a stage-adjusted approach in a homogenous, contemporary radical cystectomy (RC) cohort.</p> </sec> <sec> <title id="sectitle0020">Material and methods</title> <p id="abspara0015">We prospectively collected data of 517 UCB patients treated with RC and pelvic lymphadenectomy without neoadjuvant chemotherapy at our institution between 1996 and 2010. Stage-adjusted uni- and multivariable Cox regression models analyzed the association of gender with disease recurrence, cancer-specific mortality and overall survival.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">In total, 398 (77%) patients were male and 119 (23%) were female. Compared to men, women were more likely to have advanced tumor stages (<italic>p</italic> = 0.017), nodal metastasis (<italic>p</italic> = 0.047) and received more frequently adjuvant chemotherapy (<italic>p</italic> = 0.009). At a median follow-up of 44 months, there was no statistical difference in disease recurrence, cancer-specific mortality and overall survival between both genders when analyzed as a group. In stage-adjusted analyses, only women with non-invasive UCB were more likely to die of UCB compared to the male counterparts (<italic>p</italic> = 0.013). In gender-specific multivariable analyses that adjusted for standard clinico-pathologic features, pathologic tumor stage was an independent predictor for disease recurrence (<italic>p</italic>-values ≤0.047) and cancer-specific mortality (<italic>p</italic>-values ≤0.049), respectively.</p> </sec> <sec> <title id="sectitle0030">Conclusion</title> <p id="abspara0025">Women present with more aggressive tumor biologic features at RC, however this did not translate into inferior outcomes compared to men in stage-specific analyses in our cohort. Tumor stage is the most important factor influencing the course of disease in both genders. Validation of our findings is warranted in a larger cohort.</p> </sec> </abstract>