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01.10.2013 | Topic paper

Female gender is associated with higher risk of disease recurrence in patients with primary T1 high-grade urothelial carcinoma of the bladder

verfasst von: Luis A. Kluth, Harun Fajkovic, Evanguelos Xylinas, Joseph J. Crivelli, Niccolo Passoni, Morgan Rouprêt, Andreas Becker, Evi Comploj, Armin Pycha, Sten Holmang, Amit Gupta, Yair Lotan, Pierre I. Karakiewicz, Paolo Gontero, Felix K.-H. Chun, Margit Fisch, Douglas S. Scherr, Shahrokh F. Shariat

Erschienen in: World Journal of Urology | Ausgabe 5/2013

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Abstract

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.

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Titel: Female gender is associated with higher risk of disease recurrence in patients with primary T1 high-grade urothelial carcinoma of the bladder
verfasst von: Luis A. Kluth
Harun Fajkovic
Evanguelos Xylinas
Joseph J. Crivelli
Niccolo Passoni
Morgan Rouprêt
Andreas Becker
Evi Comploj
Armin Pycha
Sten Holmang
Amit Gupta
Yair Lotan
Pierre I. Karakiewicz
Paolo Gontero
Felix K.-H. Chun
Margit Fisch
Douglas S. Scherr
Shahrokh F. Shariat
Publikationsdatum: 01.10.2013
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 5/2013
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-012-0996-9

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Female gender is associated with higher risk of disease recurrence in patients with primary T1 high-grade urothelial carcinoma of the bladder