Cargando…
The Effect of Sex on Disease Stage and Survival after Radical Cystectomy in Non-Urothelial Variant-Histology Bladder Cancer
Background: Female sex in patients treated by radical cystectomy (RC) is associated with more advanced stage and worse survival. However, studies supporting these findings mostly or exclusively relied on urothelial carcinoma of the urinary bladder (UCUB) and did not address non-urothelial variant-hi...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10003431/ https://www.ncbi.nlm.nih.gov/pubmed/36902562 http://dx.doi.org/10.3390/jcm12051776 |
_version_ | 1784904605951328256 |
---|---|
author | Flammia, Rocco Simone Tufano, Antonio Chierigo, Francesco Würnschimmel, Christoph Hoeh, Benedikt Sorce, Gabriele Tian, Zhen Anceschi, Umberto Leonardo, Costantino Del Giudice, Francesco Terrone, Carlo Giordano, Antonio Morrione, Andrea Saad, Fred Shariat, Shahrokh F. Briganti, Alberto Montorsi, Francesco Chun, Felix K. H. Gallucci, Michele Karakiewicz, Pierre I. |
author_facet | Flammia, Rocco Simone Tufano, Antonio Chierigo, Francesco Würnschimmel, Christoph Hoeh, Benedikt Sorce, Gabriele Tian, Zhen Anceschi, Umberto Leonardo, Costantino Del Giudice, Francesco Terrone, Carlo Giordano, Antonio Morrione, Andrea Saad, Fred Shariat, Shahrokh F. Briganti, Alberto Montorsi, Francesco Chun, Felix K. H. Gallucci, Michele Karakiewicz, Pierre I. |
author_sort | Flammia, Rocco Simone |
collection | PubMed |
description | Background: Female sex in patients treated by radical cystectomy (RC) is associated with more advanced stage and worse survival. However, studies supporting these findings mostly or exclusively relied on urothelial carcinoma of the urinary bladder (UCUB) and did not address non-urothelial variant-histology bladder cancer (VH BCa). We hypothesized that female sex is associated with a more advanced stage and worse survival in VH BCa, similarly to that of UCUB. Materials and Methods: Within the SEER database (2004–2016), we identified patients aged ≥18 years, with histologically confirmed VH BCa, and treated with comprehensive RC. Logistic regression addressing the non-organ-confined (NOC) stage, as well as cumulative incidence plots and competing risks regression addressing CSM for females vs. males, were fitted. All analyses were repeated in stage-specific and VH-specific subgroups. Results: Overall, 1623 VH BCa patients treated with RC were identified. Of those, 38% were female. Adenocarcinoma (n = 331, 33%), neuroendocrine tumor (n = 304, 18%), and other VH (n = 317, 37%) were less frequent in females but not squamous cell carcinoma (n = 671, 51%). Across all VH subgroups, female patients had higher NOC rates than males did (68 vs. 58%, p < 0.001), and female sex was an independent predictor of NOC VH BCa (OR = 1.55, p = 0.0001). Overall, five-year cancer-specific mortality (CSM) were 43% for females vs. 34% for males (HR = 1.25, p = 0.02). Conclusion: In VH BC patients treated with comprehensive RC, female sex is associated with a more advanced stage. Independently of stage, female sex also predisposes to higher CSM. |
format | Online Article Text |
id | pubmed-10003431 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-100034312023-03-11 The Effect of Sex on Disease Stage and Survival after Radical Cystectomy in Non-Urothelial Variant-Histology Bladder Cancer Flammia, Rocco Simone Tufano, Antonio Chierigo, Francesco Würnschimmel, Christoph Hoeh, Benedikt Sorce, Gabriele Tian, Zhen Anceschi, Umberto Leonardo, Costantino Del Giudice, Francesco Terrone, Carlo Giordano, Antonio Morrione, Andrea Saad, Fred Shariat, Shahrokh F. Briganti, Alberto Montorsi, Francesco Chun, Felix K. H. Gallucci, Michele Karakiewicz, Pierre I. J Clin Med Article Background: Female sex in patients treated by radical cystectomy (RC) is associated with more advanced stage and worse survival. However, studies supporting these findings mostly or exclusively relied on urothelial carcinoma of the urinary bladder (UCUB) and did not address non-urothelial variant-histology bladder cancer (VH BCa). We hypothesized that female sex is associated with a more advanced stage and worse survival in VH BCa, similarly to that of UCUB. Materials and Methods: Within the SEER database (2004–2016), we identified patients aged ≥18 years, with histologically confirmed VH BCa, and treated with comprehensive RC. Logistic regression addressing the non-organ-confined (NOC) stage, as well as cumulative incidence plots and competing risks regression addressing CSM for females vs. males, were fitted. All analyses were repeated in stage-specific and VH-specific subgroups. Results: Overall, 1623 VH BCa patients treated with RC were identified. Of those, 38% were female. Adenocarcinoma (n = 331, 33%), neuroendocrine tumor (n = 304, 18%), and other VH (n = 317, 37%) were less frequent in females but not squamous cell carcinoma (n = 671, 51%). Across all VH subgroups, female patients had higher NOC rates than males did (68 vs. 58%, p < 0.001), and female sex was an independent predictor of NOC VH BCa (OR = 1.55, p = 0.0001). Overall, five-year cancer-specific mortality (CSM) were 43% for females vs. 34% for males (HR = 1.25, p = 0.02). Conclusion: In VH BC patients treated with comprehensive RC, female sex is associated with a more advanced stage. Independently of stage, female sex also predisposes to higher CSM. MDPI 2023-02-23 /pmc/articles/PMC10003431/ /pubmed/36902562 http://dx.doi.org/10.3390/jcm12051776 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Flammia, Rocco Simone Tufano, Antonio Chierigo, Francesco Würnschimmel, Christoph Hoeh, Benedikt Sorce, Gabriele Tian, Zhen Anceschi, Umberto Leonardo, Costantino Del Giudice, Francesco Terrone, Carlo Giordano, Antonio Morrione, Andrea Saad, Fred Shariat, Shahrokh F. Briganti, Alberto Montorsi, Francesco Chun, Felix K. H. Gallucci, Michele Karakiewicz, Pierre I. The Effect of Sex on Disease Stage and Survival after Radical Cystectomy in Non-Urothelial Variant-Histology Bladder Cancer |
title | The Effect of Sex on Disease Stage and Survival after Radical Cystectomy in Non-Urothelial Variant-Histology Bladder Cancer |
title_full | The Effect of Sex on Disease Stage and Survival after Radical Cystectomy in Non-Urothelial Variant-Histology Bladder Cancer |
title_fullStr | The Effect of Sex on Disease Stage and Survival after Radical Cystectomy in Non-Urothelial Variant-Histology Bladder Cancer |
title_full_unstemmed | The Effect of Sex on Disease Stage and Survival after Radical Cystectomy in Non-Urothelial Variant-Histology Bladder Cancer |
title_short | The Effect of Sex on Disease Stage and Survival after Radical Cystectomy in Non-Urothelial Variant-Histology Bladder Cancer |
title_sort | effect of sex on disease stage and survival after radical cystectomy in non-urothelial variant-histology bladder cancer |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10003431/ https://www.ncbi.nlm.nih.gov/pubmed/36902562 http://dx.doi.org/10.3390/jcm12051776 |
work_keys_str_mv | AT flammiaroccosimone theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT tufanoantonio theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT chierigofrancesco theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT wurnschimmelchristoph theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT hoehbenedikt theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT sorcegabriele theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT tianzhen theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT anceschiumberto theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT leonardocostantino theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT delgiudicefrancesco theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT terronecarlo theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT giordanoantonio theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT morrioneandrea theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT saadfred theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT shariatshahrokhf theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT brigantialberto theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT montorsifrancesco theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT chunfelixkh theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT galluccimichele theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT karakiewiczpierrei theeffectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT flammiaroccosimone effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT tufanoantonio effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT chierigofrancesco effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT wurnschimmelchristoph effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT hoehbenedikt effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT sorcegabriele effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT tianzhen effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT anceschiumberto effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT leonardocostantino effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT delgiudicefrancesco effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT terronecarlo effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT giordanoantonio effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT morrioneandrea effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT saadfred effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT shariatshahrokhf effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT brigantialberto effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT montorsifrancesco effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT chunfelixkh effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT galluccimichele effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer AT karakiewiczpierrei effectofsexondiseasestageandsurvivalafterradicalcystectomyinnonurothelialvarianthistologybladdercancer |