Annemarie Uhlig1, Arne Strauss2, Ali Seif Amir Hosseini3, Joachim Lotz3, Lutz Trojan2, Marianne Schmid2, Johannes Uhlig4. 1. Department of Urology, University Medical Center Goettingen, Goettingen, Germany. Electronic address: annemarie.uhlig@med.uni-goettingen.de. 2. Department of Urology, University Medical Center Goettingen, Goettingen, Germany. 3. Department of Radiology, University Medical Center Goettingen, Goettingen, Germany. 4. Department of Radiology, University Medical Center Goettingen, Goettingen, Germany; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
Abstract
CONTEXT: The incidence of urothelial carcinoma of the bladder (UCB) is lower in women; however, women tend to present with more advanced disease. To date, there is no quantitative synthesis of studies reporting gender-specific outcomes in non-muscle-invasive UCB. OBJECTIVE: To conduct a meta-analysis evaluating gender-specific differences in recurrence of non-muscle-invasive urinary bladder cancer (NMIBC). EVIDENCE ACQUISITION: An unrestricted systematic literature search of the MEDLINE, EMBASE, and Cochrane libraries was conducted. Studies evaluating the impact of gender on disease recurrence after local treatment of NMIBC using multivariable Cox proportional hazard models were included. Random effect meta-analysis, subgroup analyses, meta-influence, and cumulative meta-analyses were conducted. Publication bias was assessed via a funnel plot and Eggeŕs test. EVIDENCE SYNTHESIS: Of 609 studies screened, 27 comprising 23 754 patients were included. Random effect meta-analyses indicated women at increased risk for UCB recurrence compared with men (hazard ratio [HR]=1.11, 95% confidence interval [CI]: 1.01-1.23, p=0.03). Subgroup analyses yielded estimates between HR=0.99 and HR=1.68. Gender-specific differences in UCB recurrence were most pronounced in studies administering exclusively bacillus Calmette-Guerin (BCG; HR=1.64, 95% CI: 1.13-2.39, p=0.01), especially in a long-term treatment regimen (HR=1.68, 95% CI: 1.32-2.15, p<0.001). Sensitivity analyses confirmed female patients at increased risk for UCB recurrence. CONCLUSIONS: Women are at increased risk for disease recurrence after local treatment of NMIBC compared with male patients. Reduced effectiveness of BCG treatment might underlie this observation. Gender-specific differences were evident across various subgroups and proved robust upon sensitivity analyses. PATIENT SUMMARY: In this report, we combined several studies on gender-specific differences in relapse of superficial bladder cancer. Women were more likely to experience cancer relapse than men.
CONTEXT: The incidence of urothelial carcinoma of the bladder (UCB) is lower in women; however, women tend to present with more advanced disease. To date, there is no quantitative synthesis of studies reporting gender-specific outcomes in non-muscle-invasive UCB. OBJECTIVE: To conduct a meta-analysis evaluating gender-specific differences in recurrence of non-muscle-invasive urinary bladder cancer (NMIBC). EVIDENCE ACQUISITION: An unrestricted systematic literature search of the MEDLINE, EMBASE, and Cochrane libraries was conducted. Studies evaluating the impact of gender on disease recurrence after local treatment of NMIBC using multivariable Cox proportional hazard models were included. Random effect meta-analysis, subgroup analyses, meta-influence, and cumulative meta-analyses were conducted. Publication bias was assessed via a funnel plot and Eggeŕs test. EVIDENCE SYNTHESIS: Of 609 studies screened, 27 comprising 23 754 patients were included. Random effect meta-analyses indicated women at increased risk for UCB recurrence compared with men (hazard ratio [HR]=1.11, 95% confidence interval [CI]: 1.01-1.23, p=0.03). Subgroup analyses yielded estimates between HR=0.99 and HR=1.68. Gender-specific differences in UCB recurrence were most pronounced in studies administering exclusively bacillus Calmette-Guerin (BCG; HR=1.64, 95% CI: 1.13-2.39, p=0.01), especially in a long-term treatment regimen (HR=1.68, 95% CI: 1.32-2.15, p<0.001). Sensitivity analyses confirmed female patients at increased risk for UCB recurrence. CONCLUSIONS:Women are at increased risk for disease recurrence after local treatment of NMIBC compared with male patients. Reduced effectiveness of BCG treatment might underlie this observation. Gender-specific differences were evident across various subgroups and proved robust upon sensitivity analyses. PATIENT SUMMARY: In this report, we combined several studies on gender-specific differences in relapse of superficial bladder cancer. Women were more likely to experience cancer relapse than men.
Authors: Kelly A Martin; Nicholas R Hum; Aimy Sebastian; Wei He; Salma Siddiqui; Paramita M Ghosh; Chong-Xian Pan; Ralph de Vere White; Gabriela G Loots Journal: Int J Mol Sci Date: 2019-10-09 Impact factor: 5.923
Authors: Léa Deltourbe; Livia Lacerda Mariano; Teri N Hreha; David A Hunstad; Molly A Ingersoll Journal: Mucosal Immunol Date: 2022-07-22 Impact factor: 8.701
Authors: Matteo Ferro; Octavian Sabin Tătaru; Gennaro Musi; Giuseppe Lucarelli; Abdal Rahman Abu Farhan; Francesco Cantiello; Rocco Damiano; Rodolfo Hurle; Roberto Contieri; Gian Maria Busetto; Giuseppe Carrieri; Luigi Cormio; Francesco Del Giudice; Alessandro Sciarra; Sisto Perdonà; Marco Borghesi; Carlo Terrone; Evelina La Civita; Pierluigi Bove; Riccardo Autorino; Matteo Muto; Nicolae Crisan; Michele Marchioni; Luigi Schips; Francesco Soria; Daniela Terracciano; Rocco Papalia; Felice Crocetto; Biagio Barone; Giorgio Ivan Russo; Stefano Luzzago; Giuseppe Mario Ludovico; Mihai Dorin Vartolomei; Francesco Alessandro Mistretta; Vincenzo Mirone; Ottavio de Cobelli Journal: Diagnostics (Basel) Date: 2022-02-25
Authors: Stephen Chenard; Chelsea Jackson; Thiago Vidotto; Lina Chen; Céline Hardy; Tamara Jamaspishvilli; David Berman; D Robert Siemens; Madhuri Koti Journal: Eur Urol Open Sci Date: 2021-06-03