Gender-specific differences in bladder cancer: A retrospective analysis |
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| Affiliation: | 1. Department of Urology, Eberhard-Karls-University, Tübingen, Federal Republic of Germany;2. Department of Urology, Klinikum Kassel, Kassel, Federal Republic of Germany;3. Inova Q Inc., Brunico, Italy;1. Department of Radiotherapy, Ghent University Hospital, Ghent, Belgium;2. Bladder Cancer Center, Dana-Farber Cancer Institute, Boston, MA, USA;3. Department of Cancer Environment Research Unit, Léon-Bérard Cancer Center, Claude-Bernard-Lyon University, Lyon, France;4. Department of Urology, Saint-Louis Hospital, Paris, France;5. Department of Urology, Duke University Medical Center, Durham, NC, USA;6. Geriatric Department, CHU Henri Mondor, APHP, Créteil, France;7. Prostate Cancer Research, Montreal Cancer Institute/CRCHUM, Centre de Hospitalier de Université de Montréal, Montréal, QC, Canada;8. Urology Department, Saint Jean Languedoc Hospital, Toulouse, France;1. European Association of Urology Non–Muscle-Invasive Bladder Cancer Guidelines Panel, Arnhem, The Netherlands;2. Department of Urology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain;3. Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain;4. Department of Urology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy;5. Department of Pathology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic;6. Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands;7. Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany;8. Laboratory Medicine Program, University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada;9. Department of Urology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic;10. Department of Urology, Fundación Instituto Valenciano de Oncología, Valencia, Spain;11. Department of Urology, Medical University of Graz, Graz, Austria;12. Department of Urology, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, The Netherlands;13. Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands;14. Department of Urology, The Stokes Centre for Urology, Royal Surrey Hospital, Guildford, UK;15. Department of Urology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria;p. Department of Urology, Pitié Salpétrière Hospital, AP-HP, Sorbonne University, Paris, France;q. Department of Urology, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK;r. Department of Urology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France;s. Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic;t. Department of Surgical Oncology (Urology), University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Canada;u. Department of Pathology, Teaching Hospital Motol and 2nd Faculty of Medicine, Charles University Praha, Prague, Czech Republic;v. Department of Pathology, Fundación Instituto Valenciano de Oncología, Valencia, Spain;w. Department of Pathology, Medical University of Graz, Graz, Austria;x. Department of Pathology, Comprehensive Cancer Center, Medical University Vienna, Vienna General Hospital, Vienna, Austria;y. Department of Pathology, Pitié Salpétrière Hospital, AP-HP, Pierre et Marie Curie Medical School, Sorbonne University, Paris, France;z. Department of Pathology, Royal Free London NHS Foundation Trust, Royal Free Hospital, London, UK;11. Department of Pathology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain;22. Department of Pathology, Hospital Universitario Fundación Alcorcón, Madrid, Spain;33. Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands;44. Department of Pathology, Città della Salute e della Scienza, University of Torino School of Medicine, Torino, Italy;55. Department of Pathology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany;66. Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands;77. European Association of Urology Guidelines Office, Arnhem, The Netherlands;88. Department of Pathology, Tenon Hospital, AP-HP, Sorbonne University, Paris, France;1. Department of Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic;2. Department of Urology, Royal Free London NHS Foundation Trust, London, UK;3. Department of Urology, Hospital Universitario Fundación de Alcorcón, Madrid, Spain;4. Department of Urology and Paediatric Urology, Julius-Maximilians-University Würzburg, Würzburg, Germany;5. Department of Pathology, Hôpital Tenon, Assistance Publique Hopitaux de Paris, Institut Universitaire de Cancérologie GRC5, Sorbonne University, Paris, France;6. Department of Surgical Sciences, Urology, University of Turin, Turin, Italy;7. Academic Urology Unit, University of Aberdeen, Scotland, UK;8. Department of Urology, Royal Surrey County Hospital, Guildford, UK;9. Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain;10. Department of Surgical Oncology (Urology), Netherlands Cancer Institute—Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands;11. Department of Urology, Hopital Pitié—Salpêtrière, Assistance Publique Hôpitaux de Paris, Institut Universitaire de Cancérologie GRC5, Sorbonne University, Paris, France;12. Department of Urology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria;13. EAU Guidelines Office Board, European Association of Urology, Arnhem, The Netherlands;14. Department of Medicine, Health Science Centre, McMaster University, Hamilton, Ontario, Canada;15. Department of Urology, Medizinische Universität Graz, Graz, Austria;p. Department of Urology, Motol University Hospital and Second Faculty of Medicine, Charles University, Prague, Czech Republic;1. Department of Urology, 2nd Faculty of Medicine, Hospital Motol, Charles University, Prague, Czech Republic;2. Department of Urology, Medical University of Vienna, Vienna, Austria;3. Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany;4. Department of Pathology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, UPMC Paris VI, Paris, France;5. Division of Urology, Molinette Hospital, University of Studies of Torino, Torino, Italy;6. Department of Urology, Royal Surrey County Hospital, Guildford, Surrey, UK;7. Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain;8. Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands;9. Urology Department, Sorbonne Université, GRC n°5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France;10. Department of Urology, Weill Cornell Medical College, New York, NY, USA;11. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA;12. Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia;13. European Association of Urology Guidelines Office, Brussels, Belgium;14. Department of Urology, Medical University of Graz, Graz, Austria;15. Department of Urology, General University Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic;p. Department of Urology, Royal Free London NHS Foundation Trust, London, UK;q. Department of Urology, Fundación Instituto Valenciano de Oncología, Valencia, Spain;r. Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain;s. Department of Urology, University of Rennes, Rennes, France;1. Service d’Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot, Université Lyon Claude Bernard, Lyon, France;2. Hôpital Edouard Herriot, Hospices Civils de Lyon et Université Claude Bernard, Lyon, France;3. Univ. Lyon, Université Claude Bernard Lyon 1, Lyon, France |
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| Abstract: | Background: A higher incidence of bladder cancer has been reported in men compared with women. Clinical gender differences have been observed but are less well described.Objective: This retrospective analysis further examines clinical differences in the development and manifestation of bladder cancer between men and women.Methods: Consecutive male and female patients with bladder cancer treated between 1969 and 1997 at a single center (University Hospital of Innsbruck, Innsbruck, Austria) were included in the study. Patient characteristics regarding age, tumor classification, localization, and recurrence were compared between male and female patients. Statistical analysis was conducted using the t test, the χ2 test, and the Kaplan-Meier method, with the log-rank test for subgroup analysis.Results: In the 1269 patients (876 men, 393 women) who were examined, 1744 tumors were found. The male-to-female bladder cancer incidence ratio was 2.2:1. Tumors were diagnosed at a significantly younger age in men than in women (mean age: 62 years vs 67 years, respectively; P < 0.001). No difference in the histology of tumors was observed between the sexes. Muscle-invasive tumors more frequently occurred in men than in women (39.8% vs 34.5%; P = NS). In men compared with women, primary tumors were more aggressive (grade 2, 36.6% vs 28.2%; P < 0.001) and tumor recurrences were more invasive (59.0% vs 57.8%; P = NS). Tumors were more often located in the urethra in men than in women (43 [3.4%] vs 9 [1.8%]; P = 0.034), the trigonum (246 [19.8%] vs 75 [14.9%]; P < 0.001), and the bladder dome or vault (128 [10.3%] vs 37 [7.4%]; P = 0.015). Generally, no difference in survival rate was observed between the sexes; only in the subgroup of muscle-invasive tumors (n = 455) did women have a worse overall survival rate than did men (P = 0.022).Conclusions: Clinical gender differences in bladder cancer appear to have a higher incidence in men than in women. In this analysis, women were older at the age of detection, but had less-invasive and less-aggressive tumors than did men. However, women with muscle-invasive disease had a worse overall survival rate than did men in the same subset. |
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