Analysis of Sex Differences in Cancer-Specific Survival and Perioperative Mortality Following Radical Cystectomy: Results of a Large German Multicenter Study of Nearly 2500 Patients with Urothelial Carcinoma of the Bladder

Otto, Wolfgang; May, Matthias; Fritsche, Hans‐Martin; Dragun, Duska; Aziz, Atiqullah; Gierth, Michael; Trojan, Lutz; Herrmann, Edwin; Moritz, Rudolf; Ellinger, Jörg; Tilki, Derya; Büchner, Alexander; Höfner, Thomas; Brookman‐May, Sabine; Nuhn, Philipp; Gilfrich, Christian; Roigas, Jan; Zacharias, Mario; Denzinger, Stefan; Hohenfellner, Markus; Haferkamp, Axel; Müller, Stefan; Kocot, Arkadius; Riedmiller, H.; Wieland, Wolf F.; Stief, Christian G.; Bastian, Patrick J.; Burger, Maximilian

doi:10.1016/j.genm.2012.11.001

Cited by 68 publications

(50 citation statements)

References 22 publications

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“…Horstmann et al [21] described a significantly reduced 10-year survival in women undergoing radical cystectomy from 1969 to 1997. In addition, two further multicenter studies also found an impaired cancer-specific survival in women, particularly when lymphovascular invasion was present [22,23]. Interestingly, higher tumor stages were only seen in our male population.…”

Section: Discussionsupporting

confidence: 50%

Comparative Analysis of Gender-Related Differences in Symptoms and Referral Patterns prior to Initial Diagnosis of Urothelial Carcinoma of the Bladder: A Prospective Cohort Study

et al. 2014

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Objective: To analyze gender-specific differences regarding clinical symptoms, referral patterns and tumor biology prior to initial diagnosis of urothelial carcinoma of the bladder (UCB). Methods: A consecutive series of patients with an initial diagnosis of UCB was included. All patients completed a questionnaire on demographics, clinical symptoms and referral patterns. Results: In total, 68 patients (50 men, 18 women) with newly diagnosed UCB at admission for transurethral resection of bladder tumors were recruited. Dysuria was more often observed in women (55.6 vs. 38.0%, p = 0.001). Direct consultation of the urologist was conducted by 84.0% of males and 66.7% of females (p = 0.120). One third of the women saw their general practitioner and/or gynecologist once or twice (p = 0.120) before referral to the urologist. Furthermore, women were significantly more often treated for urinary tract infections than men (61.1 vs. 20.0%, p = 0.005). Cystoscopy at first presentation to the urologist was more often performed in men than women (88.0 vs. 66.7%, p = 0.068), with a more favorable tumor detection rate at first cystoscopy in men (96.0 vs. 50.0%, p < 0.001). Conclusions: Delayed referral patterns might lead to deferred diagnosis of UCB and consequently to adverse outcome. Thus, primary care physicians might consider referring patients with bladder complaints to specialized care earlier.

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Section: Discussionsupporting

confidence: 50%

Comparative Analysis of Gender-Related Differences in Symptoms and Referral Patterns prior to Initial Diagnosis of Urothelial Carcinoma of the Bladder: A Prospective Cohort Study

et al. 2014

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Section: Discussionmentioning

confidence: 93%

“…Otto et al analysed the impact of gender on the outcome of a large retrospective cystectomy multicentre data base (n = 2,483) [15]. In this series, the 5 years CSS was significantly lower for women (60 vs. 66%, p = 0.005) [15].…”

Section: Discussionmentioning

confidence: 99%

“…In this series, the 5 years CSS was significantly lower for women (60 vs. 66%, p = 0.005) [15]. Among other factors, female gender was an independent predictive factor for CSS in a multivariate analysis [15]. Mitra et al performed matched-pair comparison based on demographics, tumour and treatment characteristics of patients undergoing radical cystectomy [16].…”

Section: Discussionmentioning

confidence: 99%

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Sex Differences of ≥pT1 Bladder Cancer Survival in Austria: A Descriptive, Long-Term, Nation-Wide Analysis Based on 27,773 Patients

Waldhoer¹,

Berger²,

Haidinger³

et al. 2015

Urol Int

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Introduction: In recent days, the relationship between gender, tumour stage and survival of bladder cancer has attracted interest. Materials and Methods: The Austrian cancer registry was linked to the national death statistics. All patients with urothelial cancer of the urinary bladder with stages pT1, pT2, pT3 and pT4 diagnosed between 1983 until 2012 were followed for up to 15 years. Overall and cancer-specific mortality were estimated by cumulative incidence. Results: A total of 27,773 patients were analysed. The male:female ratio declined from 3:1 for stage pT1-tumours (n = 16,416) to 2.6:1 for pT2 (n = 6,548), 2.1:1 for pT3 (n = 3,111) and 1.9:1 for pT4 (n = 1,698). The 5 years cumulative overall death rate for pT1 tumours was slightly lower for women (0.31 vs. 0.32; p = 0.016). The opposite was observed for more advanced tumour stages: pT2: women 0.66, men: 0.60 (p = 0.0001); pT3: women 0.76, men 0.72 (p = 0.0004) and for pT4: women 0.90, men 0.85 (p = 0.0001). Cancer-specific survival was identical for pT1-tumours in both sexes, while women had a worse cancer-specific survival in both age cohorts (<70 years and ≥70 years) with higher tumour stages. Conclusions: This population-based study demonstrates that (1) a rise of advanced bladder cancer stages in women and (2) that women with tumour stages >pT1 have a shorter cancer-specific and overall survival.

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“…6,7 However, the relationship between obesity and bladder cancer is less well defined, with conflicting conclusions reported in the literature on the impact of obesity on surgery-related mortality. 8 Several investigators have reported that obesity is independently associated with a higher risk of perioperative complications after radical cystectomy, and can lead to increased technical challenges during the procedure. 9,10 By contrast, preoperative nutritional deficiency is a risk factor for increased mortality and poor overall survival after radical cystectomy for bladder cancer.…”

Section: Introductionmentioning

confidence: 99%

Obesity and prognosis in muscle‐invasive bladder cancer: The continuing controversy

et al. 2014

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Abbreviations & AcronymsObjectives: To investigate the association between body mass index and clinicopathological features of bladder cancer, and to assess the prognostic value of body mass index in patients undergoing radical cystectomy for bladder cancer. Methods: The medical records of 714 patients who underwent radical cystectomy for bladder cancer were reviewed. The association of body mass index at surgery with clinicopathological features was examined, and the prognostic value of body mass index for recurrence-free survival and cancer-specific survival was analyzed using the Kaplan-Meier method and Cox regression models. Additional survival analyses were carried out in a subgroup of 534 patients with N0M0 disease. Results: Of 714 patients, 304 (42.6%), 184 (25.8%) and 226 (31.7%) had a body mass index of <23 (normal), 23-25 (overweight), and ≥25 (obese) kg/m 2 , respectively. Patients with high body mass index had a lower pathological T stage, fewer lymph node metastases and a lower frequency of lymphovascular invasion than those with low body mass index (P < 0.05). Multivariable analysis showed that obese status was an independent predictor of recurrencefree survival (obese vs normal: P < 0.001; overweight vs normal: P = 0.008) and cancerspecific survival (obese vs normal: P < 0.001; overweight vs normal: P = 0.019), along with pathological T stage, lymph node metastasis, and lymphovascular invasion. In addition, obesity was significantly associated with recurrence-free survival (P = 0.018) and cancerspecific survival (P = 0.019) in patients with N0M0 status. Conclusions: The present findings suggest that overweight and obesity are associated with favorable pathological features and prognosis in patients with bladder cancer undergoing radical cystectomy.

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Analysis of Sex Differences in Cancer-Specific Survival and Perioperative Mortality Following Radical Cystectomy: Results of a Large German Multicenter Study of Nearly 2500 Patients with Urothelial Carcinoma of the Bladder

Cited by 68 publications

References 22 publications

Comparative Analysis of Gender-Related Differences in Symptoms and Referral Patterns prior to Initial Diagnosis of Urothelial Carcinoma of the Bladder: A Prospective Cohort Study

Comparative Analysis of Gender-Related Differences in Symptoms and Referral Patterns prior to Initial Diagnosis of Urothelial Carcinoma of the Bladder: A Prospective Cohort Study

Sex Differences of ≥pT1 Bladder Cancer Survival in Austria: A Descriptive, Long-Term, Nation-Wide Analysis Based on 27,773 Patients

Obesity and prognosis in muscle‐invasive bladder cancer: The continuing controversy

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