Gender differences in radical nephroureterectomy for upper tract urothelial carcinoma. Academic Article Article uri icon

Overview

MeSH

  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Disease Progression
  • Female
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Kidney Diseases
  • Kidney Failure, Chronic
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Taiwan
  • Treatment Outcome
  • Urothelium

MeSH Major

  • Carcinoma
  • Nephrons
  • Sex Characteristics
  • Ureter
  • Urologic Neoplasms
  • Urologic Surgical Procedures

abstract

  • Women have been associated with adverse outcomes after radical cystectomy for lower tract urothelial carcinoma. We evaluated the prognostic value of gender in an international cohort of patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). We retrospectively studied 754 patients treated with RNU for UTUC without neoadjuvant chemotherapy at nine centers located in Asia, Canada, and Europe. Univariable and multivariable Cox regression analyses were used to address recurrence-free (RFS) and cancer-specific survival (CSS) estimates. Median follow-up was 40 months (interquartile range: 18-75). The majority of patients was of men (516, 68.4%). Women were older than men at the time of RNU (median: 69.2 vs. 66.5 years; P = 0.0003). Women were less likely to have high-grade disease, undergo lymph node dissection, and to receive adjuvant chemotherapy. Gender was not associated with pathologic stage, lymph node metastasis, lymphovascular invasion, concomitant CIS, tumor architecture, or tumor necrosis. On univariable Cox regression analyses, there was no association between gender and cancer recurrence (P = 0.76) or cancer-specific mortality (P = 0.30). On multivariable Cox regression analyses that adjusted for the effects of clinicopathologic features, gender was not associated with disease recurrence (P = 0.47) or cancer-specific survival (P = 0.15). We found no difference in histopathologic features and outcomes between men and women treated with RNU for UTUC. Nevertheless, epidemiologic and mechanistic molecular studies should be encouraged to design, analyze, and report gender-specific associations to aid in our understanding of gender impact on UTUC incidence, progression, and metastasis.

publication date

  • August 2011

has subject area

  • Aged
  • Aged, 80 and over
  • Carcinoma
  • Chronic Disease
  • Disease Progression
  • Female
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Kidney Diseases
  • Kidney Failure, Chronic
  • Male
  • Middle Aged
  • Nephrons
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Sex Characteristics
  • Taiwan
  • Treatment Outcome
  • Ureter
  • Urologic Neoplasms
  • Urologic Surgical Procedures
  • Urothelium

Research

keywords

  • Comparative Study
  • Journal Article

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.1007/s00345-010-0594-7

PubMed ID

  • 20886219

Additional Document Info

start page

  • 481

end page

  • 486

volume

  • 29

number

  • 4