1780 FEMALE GENDER IS ASSOCIATED WITH HIGHER RISK OF DISEASE RECURRENCE IN PATIENTS WITH PRIMARY T1 HIGH GRADE UROTHELIAL CARCINOMA OF THE BLADDER
Bibliographic record
Abstract
You have accessJournal of UrologyBladder Cancer: Superficial (II)1 Apr 20131780 FEMALE GENDER IS ASSOCIATED WITH HIGHER RISK OF DISEASE RECURRENCE IN PATIENTS WITH PRIMARY T1 HIGH GRADE UROTHELIAL CARCINOMA OF THE BLADDER Luis A Kluth, Harun Fajkovic, Evanguelos Xylinas, Joseph J Crivelli, Niccolo Passoni, Morgan Rouprêt, Andreas Becker, Evi Comploj, Armin Pycha, Sten Holmang, Amit Gupta, Pierre I Karakiewicz, Yair Lotan, Paolo Gontero, Felix KH Chun, Douglas S Scherr, and Shahrokh F Shariat Luis A KluthLuis A Kluth New York, NY More articles by this author , Harun FajkovicHarun Fajkovic St. Poelten, Austria More articles by this author , Evanguelos XylinasEvanguelos Xylinas New York, NY More articles by this author , Joseph J CrivelliJoseph J Crivelli New York, NY More articles by this author , Niccolo PassoniNiccolo Passoni Milano, Italy More articles by this author , Morgan RouprêtMorgan Rouprêt New York, NY More articles by this author , Andreas BeckerAndreas Becker Montreal, Canada More articles by this author , Evi ComplojEvi Comploj Bolzano, Italy More articles by this author , Armin PychaArmin Pycha Bolzano, Italy More articles by this author , Sten HolmangSten Holmang Goeteborg, Sweden More articles by this author , Amit GuptaAmit Gupta Iowa City, IA More articles by this author , Pierre I KarakiewiczPierre I Karakiewicz Montreal, Canada More articles by this author , Yair LotanYair Lotan Dallas, TX More articles by this author , Paolo GonteroPaolo Gontero Torino, Italy More articles by this author , Felix KH ChunFelix KH Chun Hamburg, Germany More articles by this author , Douglas S ScherrDouglas S Scherr New York, NY More articles by this author , and Shahrokh F ShariatShahrokh F Shariat New York More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2870AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES An increasing body of evidence suggests that gender impacts the presentation and prognosis of urothelial carcinoma of the bladder (UCB). The aim of this study was to assess the impact of gender on clinical outcomes in a large cohort of patients with clinical primary T1 high grade (HG) UCB. METHODS In this multi-institutional study, we retrospectively analyzed the data from 916 patients with primary T1 HG UCB from 7 centers between 1996 and 2007. Patients were treated with transurethral resection of the bladder with or without intravesical instillation therapy (IVT). Univariable and multivariable cox regression analyses assessed the effect of gender on outcomes. RESULTS Within a median follow-up of 42.8 months (IQR: 56), 365 (39.8%) patients experienced disease recurrence, 104 (11.4%) progression, 59 (6.4%) cancer-specific death and 190 (20.7%) death of any causes. Overall, 634 (69.2%) patients received IVT of which only 234 (25.5%) patients received BCG therapy. There was no difference between gender with regards to IVT (p=0.36) and age (p=0.45). Female gender (n=190, 20.7%) was associated with higher risk of disease recurrence (HR 1.359; 1.071-1.724, p=0.012) in all 916 patients (Figure 1) and in a subgroup of patients treated with intravesical Bacillus Calmette-Guérin (BCG) therapy (HR1.7; 1.1-2.7, p=0.017). Gender had no impact on disease progression, cancer-specific mortality and all-cause mortality. Tumour size and number of tumours were independent predictors of disease progression (p=0.035 and p=0.002, respectively). The number of tumours was an independent predictor of cancer-specific and all cause mortality (p=0.003 and p<0.001, respectively). In multivariable analyses that adjusted for standard clinico-pathologic factors, gender remained an independent predictor for disease recurrence (p=0.026) when analyzed in all patients, but not in the subgroup of BCG only patients (p=0.09). CONCLUSIONS In patients with T1 HG UCB, female gender is associated with higher risk of disease recurrence, but not with more important endpoints such as progression. This gender disparity may be due to differences in care and/or biology of UCB. Further research is necessary to understand and close the gender gap in UCB prognosis. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e731-e732 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luis A Kluth New York, NY More articles by this author Harun Fajkovic St. Poelten, Austria More articles by this author Evanguelos Xylinas New York, NY More articles by this author Joseph J Crivelli New York, NY More articles by this author Niccolo Passoni Milano, Italy More articles by this author Morgan Rouprêt New York, NY More articles by this author Andreas Becker Montreal, Canada More articles by this author Evi Comploj Bolzano, Italy More articles by this author Armin Pycha Bolzano, Italy More articles by this author Sten Holmang Goeteborg, Sweden More articles by this author Amit Gupta Iowa City, IA More articles by this author Pierre I Karakiewicz Montreal, Canada More articles by this author Yair Lotan Dallas, TX More articles by this author Paolo Gontero Torino, Italy More articles by this author Felix KH Chun Hamburg, Germany More articles by this author Douglas S Scherr New York, NY More articles by this author Shahrokh F Shariat New York More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".