Urothelial cancer: Gender discrepancies and impact on overall survival.
Bibliographic record
Abstract
e15020 Background: Gender differences for disease course and survival in various cancers exist. Gender disparity for both stage at diagnosis and overall survival (OS) has been observed in urothelial cancer (UC). We report a single institution analysis of UC patients treated with chemotherapy to further investigate gender differences in outcomes. Methods: We identified 190 bladder cancer pts treated with chemotherapy (adjuvant of palliative) since 2002. Age and stage at diagnosis, sex, smoking status, radiation/chemical exposures, bloodwork as a measure of organ dysfunction, ECOG performance status (PS), pathology, chemotherapies, presenting symptoms, other malignancies, and survival info was collected. Baseline demographics were compared by z test for significance and outcomes using chi square statistic. Survival was determined by censored Kaplan-Meier methods. Results: Average age and stage at diagnosis, and PS were similar for both genders. Males had significantly more exposure to smoking (58% vs 48%, p<0.05) and radiation/chemical exposures (28% vs 10%, p<0.05). Invasive urothelial carcinoma was the predominant histological diagnosis for both genders, but males were found to have significantly more subtypes or other pathologies (22.2% vs 14%, p<0.05). Males were found to have more malignancies diagnosed prior to or concurrently with their UC diagnosis (27.8% vs 20%, p<0.05). Standard Gem-Cis was given more often to males (70% vs 49%, p<0.01) despite no differences in age, organ dysfunction or PS between genders. Receiving alternative chemotherapy in the first-line setting was associated with a poorer 3-year OS (p<0.05) for either sex, as was stage of diagnosis, presence of visceral disease, creatinine, and ECOG PS (p<0.05). Conclusions: Our data suggests that poorer outcomes in females was associated with not receiving standard chemotherapy (Gem-Cis) as frequently as males, despite similar baseline characteristics. Both males and females had significantly improved OS when they received Gem-Cis as the first regimen of chemotherapy. This study reinforces the importance of administering cisplatin as initial chemotherapy to improve outcomes in UC.
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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 | 0.001 | 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 | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
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".