Gender-specific Differences in Clinicopathologic Outcomes Following Radical Cystectomy: An International Multi-institutional Study of More Than 8000 Patients
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Gender-specific Differences in Clinicopathologic Outcomes Following Radical Cystectomy: An International Multi-institutional Study of More Than 8000 Patients. / Kluth, Luis A; Rieken, Malte; Xylinas, Evanguelos; Kent, Matthew; Rink, Michael; Rouprêt, Morgan; Sharifi, Nasim; Jamzadeh, Asha; Kassouf, Wassim; Kaushik, Dharam; Boorjian, Stephen A; Roghmann, Florian; Noldus, Joachim; Masson-Lecomte, Alexandra; Vordos, Dimitri; Ikeda, Masaomi; Matsumoto, Kazumasa; Hagiwara, Masayuki; Kikuchi, Eiji; Fradet, Yves; Izawa, Jonathan; Rendon, Ricardo; Fairey, Adrian; Lotan, Yair; Bachmann, Alexander; Zerbib, Marc; Fisch, Margit; Scherr, Douglas S; Vickers, Andrew; Shariat, Shahrokh F.
in: EUR UROL, Jahrgang 66, Nr. 5, 2014, S. 913-919.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Gender-specific Differences in Clinicopathologic Outcomes Following Radical Cystectomy: An International Multi-institutional Study of More Than 8000 Patients
AU - Kluth, Luis A
AU - Rieken, Malte
AU - Xylinas, Evanguelos
AU - Kent, Matthew
AU - Rink, Michael
AU - Rouprêt, Morgan
AU - Sharifi, Nasim
AU - Jamzadeh, Asha
AU - Kassouf, Wassim
AU - Kaushik, Dharam
AU - Boorjian, Stephen A
AU - Roghmann, Florian
AU - Noldus, Joachim
AU - Masson-Lecomte, Alexandra
AU - Vordos, Dimitri
AU - Ikeda, Masaomi
AU - Matsumoto, Kazumasa
AU - Hagiwara, Masayuki
AU - Kikuchi, Eiji
AU - Fradet, Yves
AU - Izawa, Jonathan
AU - Rendon, Ricardo
AU - Fairey, Adrian
AU - Lotan, Yair
AU - Bachmann, Alexander
AU - Zerbib, Marc
AU - Fisch, Margit
AU - Scherr, Douglas S
AU - Vickers, Andrew
AU - Shariat, Shahrokh F
N1 - Copyright © 2013. Published by Elsevier B.V.
PY - 2014
Y1 - 2014
N2 - BACKGROUND: The impact of gender on the staging and prognosis of urothelial carcinoma of the bladder (UCB) is insufficiently understood.OBJECTIVE: To assess gender-specific differences in pathologic factors and survival of UCB patients treated with radical cystectomy (RC).DESIGN, SETTING, AND PARTICIPANTS: Data from 8102 patients treated with RC (6497 men [80%] and 1605 women [20%]) for UCB between 1971 and 2012 were analyzed.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Multivariable competing-risk regression analyses were performed to evaluate the relationship of gender on disease recurrence (DR) and cancer-specific mortality (CSM). We also tested the interaction of gender and tumor stage, nodal status, and lymphovascular invasion (LVI).RESULTS AND LIMITATIONS: Female patients were older at the time of RC (p=0.033) and had higher rates of pathologic stage T3/T4 disease (p<0.001). In univariable, but not in multivariable analysis, female gender was associated with a higher risk of DR (p=0.022 and p=0.11, respectively). Female gender was an independent predictor for CSM (p=0.004). We did not find a significant interaction between gender and stage, nodal metastasis, or LVI (all p values >0.05).CONCLUSIONS: We found female gender to be associated with a higher risk of CSM following RC. However, these findings do not appear to be explained by gender differences in pathologic stage, nodal status, or LVI. This gender disparity may be due to differences in care and/or the biology of UCB.
AB - BACKGROUND: The impact of gender on the staging and prognosis of urothelial carcinoma of the bladder (UCB) is insufficiently understood.OBJECTIVE: To assess gender-specific differences in pathologic factors and survival of UCB patients treated with radical cystectomy (RC).DESIGN, SETTING, AND PARTICIPANTS: Data from 8102 patients treated with RC (6497 men [80%] and 1605 women [20%]) for UCB between 1971 and 2012 were analyzed.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Multivariable competing-risk regression analyses were performed to evaluate the relationship of gender on disease recurrence (DR) and cancer-specific mortality (CSM). We also tested the interaction of gender and tumor stage, nodal status, and lymphovascular invasion (LVI).RESULTS AND LIMITATIONS: Female patients were older at the time of RC (p=0.033) and had higher rates of pathologic stage T3/T4 disease (p<0.001). In univariable, but not in multivariable analysis, female gender was associated with a higher risk of DR (p=0.022 and p=0.11, respectively). Female gender was an independent predictor for CSM (p=0.004). We did not find a significant interaction between gender and stage, nodal metastasis, or LVI (all p values >0.05).CONCLUSIONS: We found female gender to be associated with a higher risk of CSM following RC. However, these findings do not appear to be explained by gender differences in pathologic stage, nodal status, or LVI. This gender disparity may be due to differences in care and/or the biology of UCB.
U2 - 10.1016/j.eururo.2013.11.040
DO - 10.1016/j.eururo.2013.11.040
M3 - SCORING: Journal article
C2 - 24331151
VL - 66
SP - 913
EP - 919
JO - EUR UROL
JF - EUR UROL
SN - 0302-2838
IS - 5
ER -