PURPOSE: An increasing body of evidence suggests gender differences in the presentation and prognosis of bladder cancer. We aimed to assess the impact of gender on outcomes in patients with primary T1 high-grade (HG) urothelial carcinoma of the bladder (UCB). METHODS: We retrospectively analysed the data from 916 patients with primary T1HG UCB from 7 tertiary care centres. Patients were treated with transurethral resection of the bladder with or without intravesical instillation therapy (IVT). Univariable and multivariable Cox regression analyses assessed the effect of gender on outcomes. RESULTS: Within a median follow-up of 42.8 months, 365 (39.8 %) patients experienced disease recurrence, 104 (11.4 %) progression, 59 (6.4 %) cancer-specific mortality and 190 (20.7 %) mortality of any cause. Overall, 634 (69.2 %) patients received IVT of which 234 (25.5 %) received BCG therapy. Female gender (n = 190, 20.7 %) was associated with higher risk of disease recurrence (HR:1.359;1.071-1.724, p = 0.012) in all patients and in a subgroup of patients treated with BCG therapy (HR:1.717;1.101-2.677, p = 0.017). There was no difference between genders with regard to disease progression, cancer-specific mortality and any-cause mortality. In multivariable analyses that adjusted for the effects of concomitant carcinoma in situ (CIS), tumour size, number of tumours, and IVT, gender remained an independent predictor for disease recurrence (p = 0.026) when analysed in all patients, but not in the subgroup of BCG treated patients (p = 0.093). CONCLUSIONS: In patients with T1HG UCB, female gender is associated with higher risk of disease recurrence, but not with disease progression. This gender disparity may be due to differences in care and/or biology of UCB.
PURPOSE: An increasing body of evidence suggests gender differences in the presentation and prognosis of bladder cancer. We aimed to assess the impact of gender on outcomes in patients with primary T1 high-grade (HG) urothelial carcinoma of the bladder (UCB). METHODS: We retrospectively analysed the data from 916 patients with primary T1HG UCB from 7 tertiary care centres. Patients were treated with transurethral resection of the bladder with or without intravesical instillation therapy (IVT). Univariable and multivariable Cox regression analyses assessed the effect of gender on outcomes. RESULTS: Within a median follow-up of 42.8 months, 365 (39.8 %) patients experienced disease recurrence, 104 (11.4 %) progression, 59 (6.4 %) cancer-specific mortality and 190 (20.7 %) mortality of any cause. Overall, 634 (69.2 %) patients received IVT of which 234 (25.5 %) received BCG therapy. Female gender (n = 190, 20.7 %) was associated with higher risk of disease recurrence (HR:1.359;1.071-1.724, p = 0.012) in all patients and in a subgroup of patients treated with BCG therapy (HR:1.717;1.101-2.677, p = 0.017). There was no difference between genders with regard to disease progression, cancer-specific mortality and any-cause mortality. In multivariable analyses that adjusted for the effects of concomitant carcinoma in situ (CIS), tumour size, number of tumours, and IVT, gender remained an independent predictor for disease recurrence (p = 0.026) when analysed in all patients, but not in the subgroup of BCG treated patients (p = 0.093). CONCLUSIONS: In patients with T1HG UCB, female gender is associated with higher risk of disease recurrence, but not with disease progression. This gender disparity may be due to differences in care and/or biology of UCB.
Authors: Derya Tilki; Robert S Svatek; Giacomo Novara; Michael Seitz; Guilherme Godoy; Pierre I Karakiewicz; Wassim Kassouf; Yves Fradet; Hans-Martin Fritsche; Guru Sonpavde; Jonathan I Izawa; Vincenzo Ficarra; Seth P Lerner; Mark Schoenberg; Christian G Stief; Colin P Dinney; Eila Skinner; Yair Lotan; Arthur I Sagalowsky; Oliver Reich; Shahrokh F Shariat Journal: J Urol Date: 2010-09 Impact factor: 7.450
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: Jesus Fernandez-Gomez; Rosario Madero; Eduardo Solsona; Miguel Unda; Luis Martinez-Piñeiro; Marcelino Gonzalez; Jose Portillo; Antonio Ojea; Carlos Pertusa; Jesus Rodriguez-Molina; Jose Emilio Camacho; Mariano Rabadan; Ander Astobieta; Manuel Montesinos; Santiago Isorna; Pedro Muntañola; Anabel Gimeno; Miguel Blas; Jose Antonio Martinez-Piñeiro Journal: J Urol Date: 2009-09-16 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