1597 GENDER DIFFERENCES IN PATIENTS WITH BLADDER CANCER TREATED WITH RADICAL CYSTECTOMY A POPULATION-BASED ANALYSIS

You have accessJournal of UrologyBladder Cancer: Invasive II1 Apr 20121597 GENDER DIFFERENCES IN PATIENTS WITH BLADDER CANCER TREATED WITH RADICAL CYSTECTOMY A POPULATION-BASED ANALYSIS Marco Bianchi, Maxine Sun, Quoc-Dien Trinh, Jens Hansen, Zhe Tian, Niccolò Passoni, Alberto Briganti, Shahrokh Shariat, Paul Perrotte, Francesco Montorsi, and Pierre Karakiewicz Marco BianchiMarco Bianchi Milan, Italy More articles by this author , Maxine SunMaxine Sun Montreal, Canada More articles by this author , Quoc-Dien TrinhQuoc-Dien Trinh Detroit, MI More articles by this author , Jens HansenJens Hansen Hamburg, Germany New York, NY More articles by this author , Zhe TianZhe Tian Montreal, Canada More articles by this author , Niccolò PassoniNiccolò Passoni Milan, Italy More articles by this author , Alberto BrigantiAlberto Briganti Milan, Italy More articles by this author , Shahrokh ShariatShahrokh Shariat Detroit, MI More articles by this author , Paul PerrottePaul Perrotte Montreal, Canada More articles by this author , Francesco MontorsiFrancesco Montorsi Milan, Italy More articles by this author , and Pierre KarakiewiczPierre Karakiewicz Montreal, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1370AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Previously, an association between female gender and higher mortality rates in the context of bladder cancer (BCa)has been suggested. However, no existing study adjusted for competing risk of mortality. In consequence, we sought to examine the impact of gender in patients diagnosed with non-metastatic (BCa) at radical cystectomy (RC) on cancer-specific mortality (CSM) in a stage-adjusted competing-risks survival analyses. METHODS Using the Surveillance, Epidemiology and End Results database, we retrospectively identified 12843 patients diagnosed with pT1-4N0-3M0 BCa (1988-2006). Univariable and multivariable regression analyses predicting the rate of non-organ confined disease (pT3-4N0 or N1-3) at RC were fitted. Competing-risks regression analyses assessed the independent predictor status of gender on CSM. Covariates comprised age, race, pathological stage, tumor grade, socioeconomic status (SES), year of surgery, as well as other-cause mortality (OCM). Separate models were fitted according to stage of the disease and SES. RESULTS Overall, the prevalence of BCa was highest in males (75%). However, females were more likely to be older at diagnosis (mean 69 vs. 67 years, p<0.001), to be of black race (8 vs. 4%, p<0.001) and to harbor non-organ confined disease at diagnosis (39 vs. 35%, p<0.001). In multivariable analyses predicting the rate of non-organ confined disease at RC, women were significantly more likely to harbor non-organ confined disease (odds ratio [OR]: 1.18, P=0.01) than their male counterparts. Overall, the five-year CSM rates for female vs. male were 33 vs. 23% (HR: 1.22, P<0.001). In patients with organ-confined disease (pT1-2N0), the five-year CSM rates for female vs. male were 22 vs. 17% (HR: 1.24, P<0.001). In patients with non-organ confined disease (pT3-4N0-3), the five-year CSM rates for the same groups were 46 vs. 40% (HR: 1.22, P<0.001). In multivariable competing risk analyses, women were more likely to die of CSM than their male counterparts, after adjusting for OCM (hazard ratio [HR]: 1.22, P<0.001). Similarly, in patients with pT1-2 and pT3-4N0-1, female gender portended to a 1.24- and 1.22-fold higher rate of succumbing to CSM than their men counterparts, respectively (all P<0.001). Finally, in patients with low and high SES status, female patients were 1.31 and 1.15-fold more likely to die of CSM than their men counterparts (both P≤0.02). CONCLUSIONS Women were more likely to harbor more advanced disease at RC. Even after adjusting to OCM and other covariates, female gender was associated with an increased risk of CSM. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byUhlig A, Seif Amir Hosseini A, Simon J, Lotz J, Trojan L, Schmid M and Uhlig J (2018) Gender Specific Differences in Disease-Free, Cancer Specific and Overall Survival after Radical Cystectomy for Bladder Cancer: A Systematic Review and Meta-AnalysisJournal of Urology, VOL. 200, NO. 1, (48-60), Online publication date: 1-Jul-2018. Volume 187Issue 4SApril 2012Page: e646 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Metrics Author Information Marco Bianchi Milan, Italy More articles by this author Maxine Sun Montreal, Canada More articles by this author Quoc-Dien Trinh Detroit, MI More articles by this author Jens Hansen Hamburg, Germany New York, NY More articles by this author Zhe Tian Montreal, Canada More articles by this author Niccolò Passoni Milan, Italy More articles by this author Alberto Briganti Milan, Italy More articles by this author Shahrokh Shariat Detroit, MI More articles by this author Paul Perrotte Montreal, Canada More articles by this author Francesco Montorsi Milan, Italy More articles by this author Pierre Karakiewicz Montreal, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

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