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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...

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Autores principales: 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.
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
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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.
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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
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