SIU 2017: Discerning Predictors for Gender Differences in Survival Outcomes for Patients Treated for Bladder Cancer

Lisbon, Portugal (  Radical cystectomy (RC) is an underutilized treatment option for those with refractory non-muscle invasive and muscle-invasive bladder cancer; however, use of RC may differ according to gender. The authors wanted to discern receipt and timing of RC as well as survival outcomes according to gender.

A total of 49,974 patients aged 66 years or older diagnosed with clinical stage TI-IV N0M0 bladder cancer from January 1, 2001 to December 31, 2011 from SEER-Medicare data were analyzed. Multivariable regression analyses were used to identify factors predicting the use and delay of RC. Cox proportional hazards models were used to analyze survival outcomes.

Of the 49,974 patients diagnosed with bladder cancer 13,015 (26.0%) were female. Women were significantly more likely to undergo RC across all stages compared to their male counterparts (Stage I: Relative Risk (RR) 1.53, 95% Confidence Interval (CI) = 1.27-1.84, P< 0,001; Stage II: RR 1.52, 95% CI = 1.37-1.70, P< 0,001; Stage III: RR 1.26, 95% CI = 1.15-1.39, P< 0,001; Stage IV: RR 1.37,95%CI = 1.17-1.47, P < .001). Moreover, there was no significant difference in delay to RC except in women with stage IV disease, who were less likely to have delay to RC than men (RR 0.67, 95% CI = 0.62-0.95, p=0.017). Using propensity score matching, women had improved overall (HR 0.85, CI 0,82-0.88, P<0,001), but worse cancer-specific Survival (HR 1.08, CI 1.02-1.15, P=0.008) than men, respectively.

In conclusion, gender differences persist, with women who are significantly more likely to undergo RC, independent of clinical stage. However, women have significantly worse cancer-specific survival than men.

Presented by: Christopher Kosarek
Affiliation: The University of Texas Medical Branch, Galveston, United States

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre.Twitter: @GoldbergHanan at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal


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