BACKGROUND: Renal cell carcinoma (RCC) occurs twice as often in men as in women; however, the influence of gender on stage, grade, subtype and prognosis has not been studied in detail. METHODS: This study included 780 patients treated by (partial) nephrectomy at our institution in Marburg between 1990 and 2005. The mean follow-up was 5.44 years. RESULTS: Of the 780 patients, 486 (62%) were men and 294 (38%) were women. Women were significantly older (mean, 65.3 vs. 62.2 years; p<0.001, t-test), presented at lower T stages (p=0.046, chi(2)) and suffered metastasis less frequently at diagnosis (p=0.026, chi(2)). In addition, women more frequently had clear cell tumours (85.2% vs. 78.3%) and less frequently papillary tumours (11.0% vs. 18.8%) than men (p=0.026, chi(2)). In contrast, men had an increased risk of death from RCC (HR 1.23, CI 0.92-1.63); Kaplan-Meier curves revealed a significant difference in tumour-specific survival between men and women (p=0.033, log rank; 5-year survival 74% vs. 83%). However, unlike tumour stage and tumour grade, gender could not be retained as a significant independent prognostic marker in multivariate analysis. CONCLUSION: In general, RCC in men is characterized by higher tumour stages and more frequent metastasis at diagnosis along with inferior tumour-specific survival. However, as gender failed to qualify as an independent prognostic marker for tumour-specific survival, delayed diagnosis due to insufficient routine medical check-up and/or a more aggressive tumour biology might be be a concurrent cause. Thorough regular medical check-ups for men, also with regard to RCC, are thus mandatory.
BACKGROUND:Renal cell carcinoma (RCC) occurs twice as often in men as in women; however, the influence of gender on stage, grade, subtype and prognosis has not been studied in detail. METHODS: This study included 780 patients treated by (partial) nephrectomy at our institution in Marburg between 1990 and 2005. The mean follow-up was 5.44 years. RESULTS: Of the 780 patients, 486 (62%) were men and 294 (38%) were women. Women were significantly older (mean, 65.3 vs. 62.2 years; p<0.001, t-test), presented at lower T stages (p=0.046, chi(2)) and suffered metastasis less frequently at diagnosis (p=0.026, chi(2)). In addition, women more frequently had clear cell tumours (85.2% vs. 78.3%) and less frequently papillary tumours (11.0% vs. 18.8%) than men (p=0.026, chi(2)). In contrast, men had an increased risk of death from RCC (HR 1.23, CI 0.92-1.63); Kaplan-Meier curves revealed a significant difference in tumour-specific survival between men and women (p=0.033, log rank; 5-year survival 74% vs. 83%). However, unlike tumour stage and tumour grade, gender could not be retained as a significant independent prognostic marker in multivariate analysis. CONCLUSION: In general, RCC in men is characterized by higher tumour stages and more frequent metastasis at diagnosis along with inferior tumour-specific survival. However, as gender failed to qualify as an independent prognostic marker for tumour-specific survival, delayed diagnosis due to insufficient routine medical check-up and/or a more aggressive tumour biology might be be a concurrent cause. Thorough regular medical check-ups for men, also with regard to RCC, are thus mandatory.
Authors: Jean-Jacques Patard; Emmanuelle Leray; Nathalie Rioux-Leclercq; Luca Cindolo; Vincenzo Ficarra; Amnon Zisman; Alexandre De La Taille; Jacques Tostain; Walter Artibani; Claude C Abbou; Bernard Lobel; François Guillé; Dominique K Chopin; Peter F A Mulders; Christopher G Wood; David A Swanson; Robert A Figlin; Arie S Belldegrun; Allan J Pantuck Journal: J Clin Oncol Date: 2005-04-20 Impact factor: 44.544
Authors: J S Mandel; J K McLaughlin; B Schlehofer; A Mellemgaard; U Helmert; P Lindblad; M McCredie; H O Adami Journal: Int J Cancer Date: 1995-05-29 Impact factor: 7.396
Authors: A Rose Brannon; Scott M Haake; Kathryn E Hacker; Raj S Pruthi; Eric M Wallen; Matthew E Nielsen; W Kimryn Rathmell Journal: Eur Urol Date: 2011-10-18 Impact factor: 20.096
Authors: Sandra Waalkes; Faranaz Atschekzei; Mario W Kramer; Jörg Hennenlotter; Gesa Vetter; Jan U Becker; Arnulf Stenzl; Axel S Merseburger; Andres J Schrader; Markus A Kuczyk; Jürgen Serth Journal: BMC Cancer Date: 2010-09-22 Impact factor: 4.430
Authors: S Steffens; A J Schrader; Gesa Vetter; H Eggers; H Blasig; J Becker; M A Kuczyk; J Serth Journal: Oncol Lett Date: 2012-01-12 Impact factor: 2.967
Authors: Matthias May; Atiqullah Aziz; Richard Zigeuner; Thomas Chromecki; Luca Cindolo; Luigi Schips; Ottavio De Cobelli; Bernardo Rocco; Cosimo De Nunzio; Andrea Tubaro; Ioman Coman; Michael Truss; Orietta Dalpiaz; Bernd Hoschke; Christian Gilfrich; Bogdan Feciche; Anette Stoltze; Fabian Fenske; Hans-Martin Fritsche; Robert S Figenshau; Kerry Madison; Manuel Sánchez-Chapado; Maria Del Carmen Santiago Martin; Luigi Salzano; Giuseppe Lotrecchiano; Steven Joniau; Raphaela Waidelich; Christian Stief; Sabine Brookman-May Journal: World J Urol Date: 2013-04-09 Impact factor: 4.226
Authors: Sandra Steffens; Andres J Schrader; Hanna Blasig; Gesa Vetter; Hendrik Eggers; Wolfgang Tränkenschuh; Markus A Kuczyk; Jürgen Serth Journal: BMC Urol Date: 2011-12-07 Impact factor: 2.264