Keiichiro Mori1,2, Hadi Mostafaei1,3, Dmitry V Enikeev4, Ivan Lysenko1, Fahad Quhal1,5, Shoji Kimura2, Pierre I Karakiewicz6, Shin Egawa2, Shahrokh F Shariat1,7,4,8,9,10,11,12. 1. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 2. Department of Urology, The Jikei University School of Medicine, Tokyo, Japan. 3. Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 4. Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia. 5. Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia. 6. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, Canada. 7. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. 8. Department of Urology, Weill Cornell Medical College, New York, New York. 9. Department of Urology, University of Texas Southwestern, Dallas, Texas. 10. Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic. 11. Department of Urology, University of Jordan, Amman, Jordan. 12. European Association of Urology Research Foundation, Arnhem, Netherlands.
Abstract
PURPOSE: We assessed the prognostic value of sex differences in upper tract urothelial carcinoma and urothelial carcinoma of the bladder treated with radical surgery. MATERIALS AND METHODS: The PubMed®, Web of Science®, Cochrane Library and Scopus® databases were searched in July 2019 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Studies were deemed eligible if they compared overall, cancer specific, and recurrence-free survival in patients with upper tract urothelial carcinoma and urothelial carcinoma of the bladder. Formal meta-analyses were performed for these outcomes according to sex differences. RESULTS: Overall 66 studies with 100,389 patients with urothelial carcinoma of the bladder and 40 studies with 39,759 patients with upper tract urothelial carcinoma were eligible for review and meta-analysis. Female patients with urothelial carcinoma of the bladder were associated with worse cancer specific survival (pooled HR 1.20, 95% CI 1.10-1.31), overall survival (pooled HR 1.03, 95% CI 1.01-1.05) and recurrence-free survival (pooled HR 1.13, 95% CI 1.02-1.25). In contrast, those with upper tract urothelial carcinoma were not associated with cancer specific survival (pooled HR 0.94, 95% CI 0.89-1.00), overall survival (pooled HR 0.98, 95% CI 0.95-1.01) and recurrence-free survival (pooled HR 0.90, 95% CI 0.78-1.03). CONCLUSIONS: Sex is associated with cancer specific mortality, overall mortality and disease recurrence in urothelial carcinoma of the bladder but not in upper tract urothelial carcinoma. Given the genetic and social differences between the sexes, sex differences may represent a key factor in the clinical decision making process.
PURPOSE: We assessed the prognostic value of sex differences in upper tract urothelial carcinoma and urothelial carcinoma of the bladder treated with radical surgery. MATERIALS AND METHODS: The PubMed®, Web of Science®, Cochrane Library and Scopus® databases were searched in July 2019 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Studies were deemed eligible if they compared overall, cancer specific, and recurrence-free survival in patients with upper tract urothelial carcinoma and urothelial carcinoma of the bladder. Formal meta-analyses were performed for these outcomes according to sex differences. RESULTS: Overall 66 studies with 100,389 patients with urothelial carcinoma of the bladder and 40 studies with 39,759 patients with upper tract urothelial carcinoma were eligible for review and meta-analysis. Female patients with urothelial carcinoma of the bladder were associated with worse cancer specific survival (pooled HR 1.20, 95% CI 1.10-1.31), overall survival (pooled HR 1.03, 95% CI 1.01-1.05) and recurrence-free survival (pooled HR 1.13, 95% CI 1.02-1.25). In contrast, those with upper tract urothelial carcinoma were not associated with cancer specific survival (pooled HR 0.94, 95% CI 0.89-1.00), overall survival (pooled HR 0.98, 95% CI 0.95-1.01) and recurrence-free survival (pooled HR 0.90, 95% CI 0.78-1.03). CONCLUSIONS: Sex is associated with cancer specific mortality, overall mortality and disease recurrence in urothelial carcinoma of the bladder but not in upper tract urothelial carcinoma. Given the genetic and social differences between the sexes, sex differences may represent a key factor in the clinical decision making process.
Authors: Keiichiro Mori; Takafumi Yanagisawa; Satoshi Katayama; Ekaterina Laukhtina; Benjamin Pradere; Hadi Mostafaei; Fahad Quhal; Pawel Rajwa; Marco Moschini; Francesco Soria; David D'andrea; Mohammad Abufaraj; Simone Albisinni; Wojciech Krajewski; Wataru Fukuokaya; Jun Miki; Takahiro Kimura; Shin Egawa; Jeremy Yc Teoh; Shahrokh F Shariat Journal: World J Urol Date: 2022-08-13 Impact factor: 3.661