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Erschienen in:

01.10.2012 | Original Article

Gender-dependent cancer-specific survival following radical cystectomy

verfasst von: Matthias May, Christian Stief, Sabine Brookman-May, Wolfgang Otto, Christian Gilfrich, Jan Roigas, Mario Zacharias, Wolf F. Wieland, Hans-Martin Fritsche, Ferdinand Hofstädter, Maximilian Burger

Erschienen in: World Journal of Urology | Ausgabe 5/2012

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Abstract

Objective

To assess the impact of detailed clinical and histopathological criteria on gender-dependent cancer-specific survival (CSS) in a large consecutive series of patients following radical cystectomy (RCE) for muscle-invasive bladder cancer (MIBC).

Patients and methods

Between 1992 and 2007, 388 men and 133 women (25.5%) underwent RCE for MIBC. A prospectively maintained database was analysed retrospectively. Uni- and multivariable Cox-regression analyses calculated the impact of detailed clinical and histopathological criteria on CSS. Median follow-up was 59 months (2–162).

Results

Among clinical and histopathological parameters, only type of urinary diversion differed between men and women. In univariable analysis, CSS did not differ between genders. In multivariable Cox-regression analysis, advanced pT-stage (HR = 2.12; P < 0.001), lymphovascular invasion (LVI) (HR = 3.47; P < 0.001), time interval between diagnosis of MIBC and RCE exceeding 90 days (HR = 2.07; P < 0.001) and female gender (HR = 1.35; P = 0.048) were related to reduced CSS. In separate multivariable Cox-models for time period of surgery between 1992 an 1999 (HR = 1.52; P = 0.050), age ≤55 years (HR = 3.00; P = 0.022), presence of LVI (HR = 1.45; P = 0.031) and female gender were associated with independent reduced CSS.

Conclusion

Established clinical and histopathological parameters do not differ significantly between both genders in the present series. Reduced CSS in women is present in historic cohorts possibly suggesting improvement in management over the last years. In particular, female gender has a significant negative impact on CSS in patients younger of age and with positive LVI status possibly suggesting different clinical phenotypes.

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Titel: Gender-dependent cancer-specific survival following radical cystectomy
verfasst von: Matthias May
Christian Stief
Sabine Brookman-May
Wolfgang Otto
Christian Gilfrich
Jan Roigas
Mario Zacharias
Wolf F. Wieland
Hans-Martin Fritsche
Ferdinand Hofstädter
Maximilian Burger
Publikationsdatum: 01.10.2012
Verlag: Springer-Verlag
Erschienen in: World Journal of Urology / Ausgabe 5/2012
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-011-0773-1

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Gender-dependent cancer-specific survival following radical cystectomy