Bladder cancer is characterized by gender-dependent disparities. To further address this issue, we analysed a prospective, multicentre cystectomy registry.
An online database was developed that included patient demographics, intra/perioperative data, surgical data and in-house complications.
Four hundred fifty-eight patients (112 [24.5%] women and 346 [75.5%] men) were analysed. Men and women were comparable regarding age (mean 68 years), body mass index (mean 26.5) and the mean Charlson score (4.8). Women had more advanced tumour-stages (pT3/pT4; women: 57.1%; men: 48.1%). The rate of incontinent urinary diversion was higher in women (83.1%) than in men (60.2%) and in a multivariate analysis, the strongest predictors were M+ status (OR 11.2), female gender (OR 6.9) and age (OR 6.5). Women had a higher intraoperative blood transfusion rate. The overall rate of in-house complications was similar in both genders (men: 32.0%, women: 32.6%). Severe (Clavien-Dindo grade >2) medical (women: 6.3%; men: 5.2%) and surgical (women: 21.5%; men: 14.4%) in-house complications, however, were more frequent in women.
This multicentre registry demonstrates several gender-related differences in patients undergoing radical cystectomy. The higher transfusion rate, the rare use of orthotopic bladder substitutes and the higher in-house complication rate underline the higher complexity of this procedure in women.
Urologia internationalis. 2017 Jun 23 [Epub ahead of print]
Tanja Gschliesser, Klaus Eredics, Ingrid Berger, Michael Szelinger, Hans Christoph Klingler, Thomas Colombo, Anton Ponholzer, Eugen Plas, Karl Grubmüller, Michael Dunzinger, Klaus Jeschke, Erich Würnschimmel, Frens Steffen Krause, Sharokh Shariat, Karl Leeb, Alexandre Pelzer, Claus Riedl, Michael Rauchenwald, Wilhelm Hübner, Clemens Brössner, Stephan Madersbacher, Cystectomy Registry of the Austrian Society of Urology
Department of Urology, Krankenhaus Wiener Neustadt, Wiener Neustadt, Austria.