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Age-specific effect of gender on upper tract urothelial carcinoma outcomes

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Abstract

The research is to evaluate the age-specific differential effects of gender on outcomes in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). Between August 1998 and October 2010, we retrospectively reviewed the data from 285 (67.7 %) men and 136 (32.3 %) women treated with RNU for UTUC at our two institutions. Kaplan–Meier survival estimates the age-specific effect of gender on cancer-specific survival (CSS). Cox proportional hazards regression analyses were used to address the effect of gender on CSS. No significant sex-related differences were found in age and diagnosis, clinicopathologic features, and treatment (all P values >0.05). Women had a 18.7 % increased risk of death from UTUC than men (hazard ratio [HR] 1.187; 95 % confidence interval [95 % CI] 1.017–1.893; P = 0.021). The survival disadvantage was only present in patients aged 59 years and older (P < 0.001). Conversely, the survival advantage for women was found in women aged 42 to 58 years (P = 0.011) and in the age group <42 years (P = 0.019). On multivariable Cox regression analyses that adjusted for the effects of clinicopathologic features, the female gender was associated with decreased CSS (P = 0.036). In conclusion, the impact of gender on UTUC outcomes after RNU is age-specific. Females who aged 59 years and older experienced worse outcomes than their male counterparts, while women in the age group <42 years and 42–58 years have better outcomes than men. Further research is needed to elucidate the molecular mechanisms underlying the age-specific differential effect of gender on UTUC outcomes.

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References

  1. Hall MC, Womack S, Sagalowsky AI, Carmody T, Erickstad MD, Roehrborn CG. Prognostic factors, recurrence, and survival in transitional cell carcinoma of the upper urinary tract: a 30-year experience in 252 patients. Urology. 1998;52:594–601.

    Article  PubMed  CAS  Google Scholar 

  2. Novara G, De Marco V, Gottardo F, Dalpiaz O, Bouygues V, Galfano A, et al. Independent predictors of cancer-specific survival in transitional cell carcinoma of the upper urinary tract: multi-institutional dataset from 3 European centers. Cancer. 2007;110:1715–22.

    Article  PubMed  Google Scholar 

  3. Cha EK, Shariat SF, Kormaksson M, Novara G, Chromecki TF, Scherr DS, et al. Predicting clinical outcomes after radical nephroureterectomy for upper tract urothelial carcinoma. Eur Urol. 2012;61:818–25.

    Article  PubMed  Google Scholar 

  4. Margulis V, Shariat SF, Matin SF, Kamat AM, Zigeuner R, Kikuchi E, et al. Outcomes of radical nephroureterectomy: a series from the upper tract urothelial carcinoma collaboration. Cancer. 2009;115:1224–33.

    Article  PubMed  Google Scholar 

  5. Roupret M, Zigeuner R, Palou J, Boehle A, Kaasinen E, Sylvester R, et al. European guidelines for the diagnosis and management of upper urinary tract urothelial cell carcinomas: 2011 update. Eur Urol. 2011;59:584–94.

    Article  PubMed  Google Scholar 

  6. Munoz JJ, Ellison LM. Upper tract urothelial neoplasms: incidence and survival during the last 2 decades. J Urol. 2000;164:1523–5.

    Article  PubMed  CAS  Google Scholar 

  7. Mungan NA, Aben KK, Schoenberg MP, Visser O, Coebergh JW, Witjes JA, et al. Gender differences in stage-adjusted bladder cancer survival. Urology. 2000;55:876–80.

    Article  PubMed  CAS  Google Scholar 

  8. Puente D, Malats N, Cecchini L, Tardon A, Garcia-Closas R, Serra C, et al. Gender-related differences in clinical and pathological characteristics and therapy of bladder cancer. Eur Urol. 2003;43:53–62.

    Article  PubMed  CAS  Google Scholar 

  9. Mungan NA, Kiemeney LA, van Dijck JA, van der Poel HG, Witjes JA. Gender differences in stage distribution of bladder cancer. Urology. 2000;55:368–71.

    Article  PubMed  CAS  Google Scholar 

  10. Lughezzani G, Sun M, Perrotte P, Shariat SF, Jeldres C, Budaus L, et al. Gender-related differences in patients with stage I to III upper tract urothelial carcinoma: results from the surveillance, epidemiology, and end results database. Urology. 2010;75:321–7.

    Article  PubMed  Google Scholar 

  11. Cheng HL, Chow NH, Tzai TS, Tong YC, Lin JS, Chan SH, et al. Prognostic significance of proliferating cell nuclear antigen expression in transitional cell carcinoma of the upper urinary tract. Anticancer Res. 1997;17:2789–93.

    PubMed  CAS  Google Scholar 

  12. Li CC, Chang TH, Wu WJ, Ke HL, Huang SP, Tsai PC, et al. Significant predictive factors for prognosis of primary upper urinary tract cancer after radical nephroureterectomy in Taiwanese patients. Eur Urol. 2008;54:1127–34.

    Article  PubMed  Google Scholar 

  13. Koga F, Nagamatsu H, Ishimaru H, Mizuo T, Yoshida K. Risk factors for the development of bladder transitional cell carcinoma following surgery for transitional cell carcinoma of the upper urinary tract. Urol Int. 2001;67:135–41.

    Article  PubMed  CAS  Google Scholar 

  14. McGrath M, Michaud DS, De Vivo I. Hormonal and reproductive factors and the risk of bladder cancer in women. Am J Epidemiol. 2006;163:236–44.

    Article  PubMed  Google Scholar 

  15. Shin A, Song YM, Yoo KY, Sung J. Menstrual factors and cancer risk among Korean women. Int J Epidemiol. 2011;40:1261–8.

    Article  PubMed  Google Scholar 

  16. Frederick L, Greene DLP, Irvin D, April Fritz, Charles Balch M, Daniel Haller G, Monica Morrow. Fleming, April Fritz, Charles M Balch, Daniel G Haller, Monica Morrow. American Joint Committee on Cancer (AJCC) staging manual. 6th editor. Philadelphia: Springer; 2002.

    Google Scholar 

  17. Epstein JI, Amin MB, Reuter VR, Mostofi FK. The world health organization/international society of urological pathology consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder. Bladder consensus conference committee. Am J Surg Pathol. 1998;22:1435–48.

    Article  PubMed  CAS  Google Scholar 

  18. Novara G, Matsumoto K, Kassouf W, Walton TJ, Fritsche HM, Bastian PJ, et al. Prognostic role of lymphovascular invasion in patients with urothelial carcinoma of the upper urinary tract: an international validation study. Eur Urol. 2010;57:1064–71.

    Article  PubMed  Google Scholar 

  19. MD VLK, MD GL, MD RAL, MD DG. Comprehensive gynecology: text with online access [Comprehensive Gynecology (Mishell/Herbst)]. 5th ed. Mosby; 2007; p. 1128.

  20. Fernandez MI, Shariat SF, Margulis V, Bolenz C, Montorsi F, Suardi N, et al. Evidence-based sex-related outcomes after radical nephroureterectomy for upper tract urothelial carcinoma: results of large multicenter study. Urology. 2009;73:142–6.

    Article  PubMed  Google Scholar 

  21. Shariat SF, Favaretto RL, Gupta A, Fritsche HM, Matsumoto K, Kassouf W, et al. Gender differences in radical nephroureterectomy for upper tract urothelial carcinoma. World J Urol. 2011;29:481–6.

    Article  PubMed  Google Scholar 

  22. Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin. 2011;61:212–36.

    Article  PubMed  Google Scholar 

  23. Harichand-Herdt S, Ramalingam SS. Gender-associated differences in lung cancer: clinical characteristics and treatment outcomes in women. Semin Oncol. 2009;36:572–80.

    Article  PubMed  CAS  Google Scholar 

  24. Hsieh CC, Trichopoulos D, Katsouyanni K, Yuasa S. Age at menarche, age at menopause, height and obesity as risk factors for breast cancer: associations and interactions in an international case-control study. Int J Cancer. 1990;46:796–800.

    Article  PubMed  CAS  Google Scholar 

  25. Dietrich K, Demidenko E, Schned A, Zens MS, Heaney J, Karagas MR. Parity, early menopause and the incidence of bladder cancer in women: a case-control study and meta-analysis. Eur J Cancer. 2011;47:592–9.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Fang-Jian Zhou.

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Liu, JY., Li, YH., Zhang, ZL. et al. Age-specific effect of gender on upper tract urothelial carcinoma outcomes. Med Oncol 30, 640 (2013). https://doi.org/10.1007/s12032-013-0640-6

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