Danijel Sikic1, Sven Wach2, Helge Taubert2, Mario Richterstetter2, Frank Kunath2, Peter J Goebell2, Stefan Schick3, Peter Olbert4, Johannes Huber5, Bernd Wullich2, Bastian Keck2. 1. Department of Urology, University Hospital Erlangen, Erlangen, Germany danijel.sikic@uk-erlangen.de. 2. Department of Urology, University Hospital Erlangen, Erlangen, Germany. 3. Tumour Centre at the Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany. 4. Department of Urology and Pediatric Urology, Philipps University of Marburg, Marburg, Germany. 5. Department of Urology, Carl Gustav Carus University Hospital, Dresden, Germany.
Abstract
AIM: To analyze female gender as a possible age-dependent prognostic factor for overall (OS) and cancer-specific survival (CSS) in patients with upper urinary tract urothelial carcinoma (UUTUC) after radical nephroureterectomy (RNU). PATIENTS AND METHODS: A total of 167 men and 101 women with UUTUC treated with RNU with bladder cuff resection at our clinic were retrospectively analyzed. Female patients were divided into pre- and post-menopausal groups and compared against male patients of the same age. We used a cut-off age of 59 years or more as a surrogate for the post-menopausal hormonal status of women. Kaplan-Meier analyses and multivariate Cox proportional hazards regression analyses were performed to analyze gender as a possible prognostic factor of OS and CSS. RESULTS: Women aged 59 years or more had a significantly worse CSS with an average of 231 months after RNU compared to 303 months for their male counterparts (p=0.011). Univariate Cox regression analysis showed a 2.44-fold higher risk of death (p=0.013), while multivariate analyses, adjusted for tumor stage and tumor grade, showed a 2.92-fold higher risk (p=0.011) of cancer-specific death for women aged 59 years or more. CONCLUSION: Female gender is an age-dependent prognostic factor for CSS for patients with UUTUC treated with RNU. Copyright
AIM: To analyze female gender as a possible age-dependent prognostic factor for overall (OS) and cancer-specific survival (CSS) in patients with upper urinary tract urothelial carcinoma (UUTUC) after radical nephroureterectomy (RNU). PATIENTS AND METHODS: A total of 167 men and 101 women with UUTUC treated with RNU with bladder cuff resection at our clinic were retrospectively analyzed. Female patients were divided into pre- and post-menopausal groups and compared against male patients of the same age. We used a cut-off age of 59 years or more as a surrogate for the post-menopausal hormonal status of women. Kaplan-Meier analyses and multivariate Cox proportional hazards regression analyses were performed to analyze gender as a possible prognostic factor of OS and CSS. RESULTS:Women aged 59 years or more had a significantly worse CSS with an average of 231 months after RNU compared to 303 months for their male counterparts (p=0.011). Univariate Cox regression analysis showed a 2.44-fold higher risk of death (p=0.013), while multivariate analyses, adjusted for tumor stage and tumor grade, showed a 2.92-fold higher risk (p=0.011) of cancer-specific death for women aged 59 years or more. CONCLUSION: Female gender is an age-dependent prognostic factor for CSS for patients with UUTUC treated with RNU. Copyright