OBJECTIVE: To assess the impact of detailed clinical and histopathological criteria on gender-dependent cancer-specific survival (CSS) in a large consecutive series of patients following radical cystectomy (RCE) for muscle-invasive bladder cancer (MIBC). PATIENTS AND METHODS: Between 1992 and 2007, 388 men and 133 women (25.5%) underwent RCE for MIBC. A prospectively maintained database was analysed retrospectively. Uni- and multivariable Cox-regression analyses calculated the impact of detailed clinical and histopathological criteria on CSS. Median follow-up was 59 months (2-162). RESULTS: Among clinical and histopathological parameters, only type of urinary diversion differed between men and women. In univariable analysis, CSS did not differ between genders. In multivariable Cox-regression analysis, advanced pT-stage (HR = 2.12; P < 0.001), lymphovascular invasion (LVI) (HR = 3.47; P < 0.001), time interval between diagnosis of MIBC and RCE exceeding 90 days (HR = 2.07; P < 0.001) and female gender (HR = 1.35; P = 0.048) were related to reduced CSS. In separate multivariable Cox-models for time period of surgery between 1992 an 1999 (HR = 1.52; P = 0.050), age ≤55 years (HR = 3.00; P = 0.022), presence of LVI (HR = 1.45; P = 0.031) and female gender were associated with independent reduced CSS. CONCLUSION: Established clinical and histopathological parameters do not differ significantly between both genders in the present series. Reduced CSS in women is present in historic cohorts possibly suggesting improvement in management over the last years. In particular, female gender has a significant negative impact on CSS in patients younger of age and with positive LVI status possibly suggesting different clinical phenotypes.
OBJECTIVE: To assess the impact of detailed clinical and histopathological criteria on gender-dependent cancer-specific survival (CSS) in a large consecutive series of patients following radical cystectomy (RCE) for muscle-invasive bladder cancer (MIBC). PATIENTS AND METHODS: Between 1992 and 2007, 388 men and 133 women (25.5%) underwent RCE for MIBC. A prospectively maintained database was analysed retrospectively. Uni- and multivariable Cox-regression analyses calculated the impact of detailed clinical and histopathological criteria on CSS. Median follow-up was 59 months (2-162). RESULTS: Among clinical and histopathological parameters, only type of urinary diversion differed between men and women. In univariable analysis, CSS did not differ between genders. In multivariable Cox-regression analysis, advanced pT-stage (HR = 2.12; P < 0.001), lymphovascular invasion (LVI) (HR = 3.47; P < 0.001), time interval between diagnosis of MIBC and RCE exceeding 90 days (HR = 2.07; P < 0.001) and female gender (HR = 1.35; P = 0.048) were related to reduced CSS. In separate multivariable Cox-models for time period of surgery between 1992 an 1999 (HR = 1.52; P = 0.050), age ≤55 years (HR = 3.00; P = 0.022), presence of LVI (HR = 1.45; P = 0.031) and female gender were associated with independent reduced CSS. CONCLUSION: Established clinical and histopathological parameters do not differ significantly between both genders in the present series. Reduced CSS in women is present in historic cohorts possibly suggesting improvement in management over the last years. In particular, female gender has a significant negative impact on CSS in patients younger of age and with positive LVI status possibly suggesting different clinical phenotypes.
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Authors: Arnulf Stenzl; Nigel C Cowan; Maria De Santis; Markus A Kuczyk; Axel S Merseburger; Maria José Ribal; Amir Sherif; J Alfred Witjes Journal: Eur Urol Date: 2011-03-23 Impact factor: 20.096
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Authors: Derya Tilki; Robert S Svatek; Pierre I Karakiewicz; Hendrik Isbarn; Oliver Reich; Wassim Kassouf; Yves Fradet; Giacomo Novara; Hans-Martin Fritsche; Patrick J Bastian; Jonathan I Izawa; Christian G Stief; Vincenzo Ficarra; Seth P Lerner; Mark Schoenberg; Colin P Dinney; Eila Skinner; Yair Lotan; Arthur I Sagalowsky; Shahrokh F Shariat Journal: J Urol Date: 2010-01 Impact factor: 7.450
Authors: D Puente; N Malats; L Cecchini; A Tardón; R García-Closas; C Serra; A Carrato; M Sala; R Boixeda; M Dosemeci; F X Real; M Kogevinas Journal: Eur Urol Date: 2003-01 Impact factor: 20.096
Authors: Yannick Lippka; Oliver Patschan; Tilmann Todenhöfer; Christian Schwentner; Andreas Gutzeit; Axel S Merseburger; Marcus Horstmann Journal: Springerplus Date: 2013-09-08
Authors: Eric C Kauffman; Brian D Robinson; Martin Downes; Katarzyna Marcinkiewicz; Srinivas Vourganti; Douglas S Scherr; Lorraine J Gudas; Nigel P Mongan Journal: Oncol Rep Date: 2013-04-23 Impact factor: 3.906