Gender difference in survival seen after radical cystectomy
Annemarie Uhlig, M.D., M.P.H., from the University Medical Center Goettingen in Germany, and colleagues conducted a systematic literature review to examine gender-specific differences in disease-free, cancer-specific, and overall survival after radical cystectomy for bladder cancer. Data were included from 59 studies published between 1998 and 2017. Disease-free survival was assessed in 30 studies with 38,321 patients, cancer-specific survival in 44 studies with 69,666 patients, and overall survival in 26 studies with 30,039 patients.
The researchers found that, compared with males, females had reduced disease-free, cancer-specific, and overall survival. In pooled estimates, the hazard ratios were 1.16, 1.23, and 1.08 for disease-free, cancer-specific, and overall survival, respectively. In subgroup analysis, impaired disease-free, cancer-specific, and overall survival was confirmed for female patients in all strata. Publication bias was seen for studies of cancer-specific survival; after adjustment for publication bias, the pooled estimated hazard ratio for cancer-specific survival was 1.13.
"Female patients who underwent radical cystectomy for bladder cancer demonstrated worse disease-free, cancer-specific, and overall survival than their male counterparts," the authors write. "The multifactorial etiology might include epidemiological differences, gender-specific health care discrepancies and hormonal influences."
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