Is there a gender effect in bladder cancer?: A population-based study of practice and outcomes.
Bibliographic record
Abstract
e15541 Background: It is well known that the incidence of bladder cancer varies by gender. Whether differences exist between women and men in extent of disease, treatment, and outcome is not well described. Here we evaluate gender differences in muscle-invasive bladder cancer using a population-based cohort. Methods: Electronic records were linked to the population-based Ontario Cancer Registry to identify all patients with bladder cancer treated with cystectomy or radiotherapy (RT) in Ontario 1994-2008. Pathology reports were reviewed for all cystectomy cases. In this study we compare extent of disease, treatment, and outcomes between women and men. Logistic regression was used to analyze factors associated with treatment choice. Cox models were used to explore the association between gender and survival. Results: 5259 patients with bladder cancer were treated with cystectomy or radical RT; 25% (1296/5259) were women. There was no gender difference in the proportion of patients treated with cystectomy [75% of women (974/1296), 73% of men (2905/3963), p = 0.189]. Among those patients treated with cystectomy, there was no difference in rates of pre-operative referral to radiation oncology [10% women (100/974), 9% men (270/2905), p = 0.371]. Among the cystectomy cohort, women were slightly more likely to have muscle-invasive disease at the time of surgery [86% (835/974) vs 80% (2335/2905), p < 0.001] but less likely to have lymph nodes dissected [68% (664/974) vs 76% (2210/2905), p < 0.001]. Five year cancer-specific survival (CSS) and overall survival (OS) did not differ between women and men (38% vs 39%, p = 0.522; 33% vs 33% p = 0.795). Among the 2944 patients with muscle-invasive urothelial carcinoma treated with cystectomy, use of chemotherapy and outcomes did not differ significantly between genders. Conclusions: Despite the greater incidence of bladder cancer among men, this population-based cohort did not demonstrate any differences in extent of disease, treatment, or outcome between genders. Pre-op MO NACT Post-op MO ACT 5 yr CSS 5 yr OS Women 17% 5% 38% 18% 35% 29% Men 18% 4% 39% 20% 36% 30% P 0.70 0.42 0.76 0.19 0.51 0.94 MO = medical oncology referral; NACT = neoadjuvant chemotherapy; ACT = adjuvant chemotherapy
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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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".