Gender-specific differences in clinicopathologic outcomes following radical cystectomy

An international multi-institutional study of more than 8000 patients

Luis A. Kluth, Malte Rieken, Evanguelos Xylinas, Matthew Kent, Michael Rink, Morgan Rouprêt, Nasim Sharifi, Asha Jamzadeh, Wassim Kassouf, Dharam Kaushik, Stephen A. Boorjian, Florian Roghmann, Joachim Noldus, Alexandra Masson-Lecomte, Dimitri Vordos, Masaomi Ikeda, Kazumasa Matsumoto, Masayuki Hagiwara, Eiji Kikuchi, Yves Fradet & 10 others Jonathan Izawa, Ricardo Rendon, Adrian Fairey, Yair Lotan, Alexander Bachmann, Marc Zerbib, Margit Fisch, Douglas S. Scherr, Andrew Vickers, Shahrokh F. Shariat

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)913-919
Number of pages7
JournalEuropean Urology
Volume66
Issue number5
DOIs
Publication statusPublished - 2014 Nov 1

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Cystectomy
Urinary Bladder
Carcinoma
Neoplasms
Mortality
Regression Analysis
Recurrence
Survival

Keywords

  • Bladder cancer
  • Disease recurrence
  • Gender
  • Prognosis
  • Radical cystectomy
  • Survival

ASJC Scopus subject areas

  • Urology

Cite this

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: European Urology, Vol. 66, No. 5, 01.11.2014, p. 913-919.

Research output: Contribution to journalArticle

Kluth, LA, Rieken, M, Xylinas, E, Kent, M, Rink, M, Rouprêt, M, Sharifi, N, Jamzadeh, A, Kassouf, W, Kaushik, D, Boorjian, SA, Roghmann, F, Noldus, J, Masson-Lecomte, A, Vordos, D, Ikeda, M, Matsumoto, K, Hagiwara, M, Kikuchi, E, Fradet, Y, Izawa, J, Rendon, R, Fairey, A, Lotan, Y, Bachmann, A, Zerbib, M, Fisch, M, Scherr, DS, Vickers, A & Shariat, SF 2014, 'Gender-specific differences in clinicopathologic outcomes following radical cystectomy: An international multi-institutional study of more than 8000 patients', European Urology, vol. 66, no. 5, pp. 913-919. https://doi.org/10.1016/j.eururo.2013.11.040
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. / Gender-specific differences in clinicopathologic outcomes following radical cystectomy : An international multi-institutional study of more than 8000 patients. In: European Urology. 2014 ; Vol. 66, No. 5. pp. 913-919.
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T1 - Gender-specific differences in clinicopathologic outcomes following radical cystectomy

T2 - 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.

PY - 2014/11/1

Y1 - 2014/11/1

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.

KW - Bladder cancer

KW - Disease recurrence

KW - Gender

KW - Prognosis

KW - Radical cystectomy

KW - Survival

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