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Female sex is an independent risk factor for reduced overall survival in bladder cancer patients treated by transurethral resection and radio- or radiochemotherapy

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Abstract

Purpose

To evaluate sex as a possible prognostic factor in bladder cancer patients treated with transurethral resection (TURBT) and radio- (RT) or radiochemotherapy (RCT).

Methods

Kaplan–Meier analyses and multiple Cox proportional hazards regression analyses were performed to analyze sex as a possible prognostic factor on the overall (OS) and cancer-specific (CSS) survival of 386 male and 105 female patients who underwent TURBT and RCT or RT with curative intent between 1982 and 2007.

Results

After a follow-up of 5 years, female sex demonstrated a hazard ratio (HR) of 1.79 (95 % CI 1.24–2.57) for OS; for CSS, the HR was 2.4 (95 % CI 1.52–3.80). Sex was an adverse prognosticator of both OS and CSS independent from age at diagnosis, cT stage, grading, concurrent cis, LVI, focality, therapy response, resection status and therapy mode. Kaplan–Meier analysis showed significantly reduced OS of women compared with men, with a median survival of 2.3 years for female patients and 5.1 years for male patients (p = 0.045, log-rank test). The estimated median CSS was 7.1 years for female patients and 12.7 years for male patients (p = 0.11, log-rank test).

Conclusions

Female sex is an independent prognostic factor for reduced OS and CSS in bladder cancer patients treated by TURBT and RT or RCT. These data are in agreement with those reported for OS after radical cystectomy in muscle-invasive bladder cancers. Therefore, further studies are strongly warranted to obtain more information about molecular differences regarding sex-specific carcinogenesis in bladder cancer and about possible therapeutic considerations.

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Acknowledgments

We thank “American Journal Experts” for providing language-editing service for our manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Urology, University Hospital Erlangen, Universitätsstraße 12, 91052, Erlangen, Germany

    Bastian Keck, Frank Kunath & Bernd Wullich

  2. Clinical Cancer Registry, Tumor Center of the University Erlangen, Erlangen, Germany

    Lothar Häberle

  3. Department of Radiation Oncology, University Hospital Erlangen, Erlangen, Germany

    Oliver J. Ott, Rolf Sauer & Rainer Fietkau

  4. Department of Radiotherapy and Oncology, University Frankfurt am Main, Frankfurt am Main, Germany

    Christian Weiss & Claus Rödel

  5. Department of Urology, AKH, General Hospital, Linz, Austria

    Frens S. Krause

  6. Department of Gynecology and Obstetrics, University Erlangen, Erlangen, Germany

    Lothar Häberle

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  1. Bastian Keck
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  2. Oliver J. Ott
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  4. Frank Kunath
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Correspondence to Bastian Keck.

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Keck, B., Ott, O.J., Häberle, L. et al. Female sex is an independent risk factor for reduced overall survival in bladder cancer patients treated by transurethral resection and radio- or radiochemotherapy. World J Urol 31, 1023–1028 (2013). https://doi.org/10.1007/s00345-012-0971-5

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  • DOI: https://doi.org/10.1007/s00345-012-0971-5

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