The effect of sex on disease stage and survival after radical cystectomy: a population-based analysis.

Published on Apr 1, 2021in Urologic Oncology-seminars and Original Investigations2.882
· DOI :10.1016/J.UROLONC.2020.09.004
Giuseppe Rosiello9
Estimated H-index: 9
(UdeM: Université de Montréal),
Carlotta Palumbo6
Estimated H-index: 6
(UdeM: Université de Montréal)
+ 11 AuthorsPierre I. Karakiewicz6
Estimated H-index: 6
(UdeM: Université de Montréal)
Abstract Background The increased awareness regarding the sex gap in bladder cancer (BCa) care over the last decade may have resulted in more timely-wise referral patterns and treatment of female patients with BCa. Thus, we tested the association of sex with disease stage at presentation, as well as with cancer-specific mortality (CSM) after radical cystectomy (RC) in a contemporary cohort of patients with nonmetastatic urothelial bladder cancer (UCUB). Methods Within the Surveillance, Epidemiology, and End Results database (2004–2016), we identified 14,086 patients (10,879 men and 3,207 women) treated with RC for non-metastatic UCUB. Temporal trend, interaction analyses, logistic regression, cumulative incidence, and competing-risks regression analyses were used. Results Overall, 10,879 (77.2%) men and 3,207 (22.8%) women underwent RC between 2004 and 2016. Female gender was an independent predictor of non-organ-confined (NOC) UCUB at RC in multivariable analyses (odds ratio: 1.23; 95% confidence intervals [CI] 1.10–1.38; P Conclusion It is worrisome that, while in men the rate of NOC is decreasing, NOC rates in females have not improved over time. Moreover, it is also worrisome that, despite adjustment for both pathological tumor and patient characteristics, female sex remains an adverse prognostic factor for CSM. Reassessment of referral, diagnostic, and treatment patterns aimed at eliminating these sex discrepancies appears warranted.
#1Laura Bukavina (Case Western Reserve University)H-Index: 6
#2Kirtishri Mishra (Case Western Reserve University)H-Index: 7
Last. Carvell T Nguyen (MetroHealth)H-Index: 4
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Abstract Background While female gender is considered a protective determinant in the majority of cancers, outcomes in women diagnosed with bladder cancer have continued to show disproportional mortality when compared with men. Objective The aim of this retrospective propensity score-matched analysis was to evaluate the intra- and postoperative differences among genders, as well as to evaluate reproductive organ-preserving radical cystectomy (ROPRC) as compared with radical cystectomy (RC) as a ...
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#1Joan PalouH-Index: 40
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Abstract This presentation considers follow-up after successful transurethral resection of a high-grade non-muscle-invasive tumour, with normal cystoscopy, followed by bacillus-Calmette-Guerin (BCG) therapy. Focusing on two possible outcomes, a positive cytology but a negative urinary biomarker result, versus positive biomarkers but a negative cytology, we discuss what the evidence and guidelines recommend and which test is more robust. Patient summary Bladder cancer is usually assessed by exami...
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#1Carlotta Palumbo (UdeM: Université de Montréal)H-Index: 6
#2Angela Pecoraro (UNITO: University of Turin)H-Index: 8
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BACKGROUND The burden of renal cell carcinoma (RCC) in young adults received marginal attention. We assessed contemporary gender, race and stage-specific incidence and trends of RCC among young adults (20-39 years-old) in the United States. METHODS Within Surveillance, Epidemiology, and End Results database (2000-2016), patients aged 20-39 years with histologically confirmed RCC were included. Age-standardized incidence rates (ASR per 100,000 person-years) were estimated. Temporal trends were ca...
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#1Sarah P. Psutka (NU: Northwestern University)H-Index: 19
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Abstract Context Perioperative and long-term functional and oncologic outcomes following radical cystectomy (RC) for localized bladder cancer remain unchanged despite advances in technique and perioperative management, as well as neoadjuvant and adjuvant therapy. Accurate assessment of a patient's perioperative risk is critical to inform preoperative counseling and determine a patient's fitness for RC. Objective To review and synthesize conventional and novel objective patient-specific risk asse...
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Abstract Context Radical cystectomy continues to be associated with a significant risk of morbidity and all-cause mortality (ACM). Practice pattern data demonstrating underuse of surgery for patients with muscle-invasive and high-risk non–muscle invasive bladder cancer (BC) have been linked to the advanced age and higher comorbidity status of such patients, which suggests that rates of ACM as well as cancer-specific mortality should be incorporated into patient counseling and guideline recommend...
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#1Salvatore Siracusano (University of Verona)H-Index: 22
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Studies comparing health-related quality of life (HR-QoL) between patients who underwent radical cystectomy (RC) and those who underwent a different form of urinary diversion has not reached yet univocal and reliable conclusions. The aim of our study was to evaluate bladder-specific long-term HR-QoL after radical cystectomy and ileal conduit.A multicenter study was carried out on 145 consecutive patients (112 males and 33 females) undergoing RC and ileal conduit (IC). HR-QoL assessment was condu...
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#1J. Alfred Witjes (Radboud University Nijmegen Medical Centre)H-Index: 88
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Abstract Context Invasive bladder cancer is a frequently occurring disease with a high mortality rate despite optimal treatment. The European Association of Urology (EAU) Muscle-invasive and Metastatic Bladder Cancer (MIBC) Guidelines are updated yearly and provides information to optimise diagnosis, treatment, and follow-up of this patient population. Objective To provide a summary of the EAU guidelines for physicians and patients confronted with muscle-invasive and metastatic bladder cancer. E...
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Abstract Context Bladder cancer has become a common cancer globally, with an estimated 430 000 new cases diagnosed in 2012. Objective We examine the most recent global bladder cancer incidence and mortality patterns and trends, the current understanding of the aetiology of the disease, and specific issues that may influence the registration and reporting of bladder cancer. Evidence acquisition Global bladder cancer incidence and mortality statistics are based on data from the International Agenc...
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Abstract Context The incidence of bladder cancer is three to four times greater in men than in women. However, women are diagnosed with more advanced disease at presentation and have less favorable outcomes after treatment. Objective To review the literature on potential biologic mechanisms underlying differential gender risk for bladder cancer, and evidence regarding gender disparities in bladder cancer presentation, management, and outcomes. Evidence acquisition A literature search of English-...
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#1Ilaria Lucca (Medical University of Vienna)H-Index: 18
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Gender discrepancy exists in the incidence of both urothelial and kidney carcinomas, and most data support the theory that gender affects the incidence and prognosis of these malignancies. Here, Lucca et al. discuss these gender differences and the biological and environmental factors that might influence them.
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Cited By4
#1Giuseppe Rosiello (UdeM: Université de Montréal)H-Index: 9
#2Carlotta Palumbo (UdeM: Université de Montréal)H-Index: 6
Last. Pierre I. Karakiewicz (UdeM: Université de Montréal)H-Index: 116
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OBJECTIVE Our objective was to investigate age- and sex-related differences in the distribution of metastases in patients with metastatic bladder cancer. METHODS Within the National Inpatient Sample database (2008-2015), we identified 7040 patients with metastatic bladder cancer. Trend test and Chi-square test analyses were used to evaluate the relationship between age and site of metastases, according to sex. RESULTS Of 7040 patients with metastatic bladder cancer, 5226 (74.2%) were men and 181...
#1Jeannie Hoffman-Censits (Johns Hopkins University)
Last. Chana Weinstock (FDA: Food and Drug Administration)H-Index: 6
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Despite recent treatment advances, kidney and bladder cancer cases have continued to rise in both incidence and mortality over the last few decades. Not every demographic subgroup of patients diagnosed with these cancers has an equivalent outcome. Women diagnosed with bladder cancer have worse overall survival than men diagnosed with bladder cancer. Older adults with muscle-invasive bladder cancer have worse cancer-specific outcomes than do younger patients. Black patients diagnosed with kidney ...
#1Leslie K. Ballas (SC: University of Southern California)H-Index: 9
#2Stephanie Navarro (SC: University of Southern California)H-Index: 1
Last. Susan Groshen (SC: University of Southern California)H-Index: 111
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INTRODUCTION In surgical series of muscle-invasive bladder cancer (MIBC), women have higher recurrence rates, disease progression, and mortality following radical cystectomy than men. Similar reports of oncologic differences between men and women following trimodality therapy (TMT) are rare. Our hypothesis was that there would be no difference in overall survival (OS) between sexes receiving TMT. METHODS We queried the National Cancer Database (NCDB) for patients diagnosed with clinical stage T2...
#1Min-Qiang Lin (Ha Tai: Xiamen University)
#2Chen-Lu Lian (Ha Tai: Xiamen University)H-Index: 1
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Background: The application of China’s big data sector in cancer research is just the beginning. In recent decades, more and more Chinese scholars have used the Surveillance, Epidemiology, and End Results (SEER) database for clinical cancer research. A comprehensive bibliometric study is required to analyze the tendency of Chinese scholars to utilize the SEER database for clinical cancer research and provide a reference for the future of big data analytics. Objective: Our study aimed to assess t...