Female sex tied to worse survival, recurrence in urothelial carcinoma of the bladder

26 Jun 2020
MOH has encouraged more students to take up oncology by increasing scholarships and facilitating training programmes.MOH has encouraged more students to take up oncology by increasing scholarships and facilitating training programmes.

Sex appears to contribute to cancer-specific mortality, overall mortality, and disease recurrence in urothelial carcinoma of the bladder, with women drawing the short straw, results of a systematic review and meta-analysis have shown.

The investigators searched PubMed, Web of Science, Cochrane Library and Scopus databases in July 2019 according to the Preferred Reporting for Systematic Reviews and Meta-Analyses statement. Studies that compared overall, cancer-specific, and recurrence-free survival in patients with upper tract urothelial carcinoma and urothelial carcinoma of the bladder were eligible for analysis. Meta-analyses were conducted for these outcomes according to sex differences.

Sixty-six studies including a total of 100,389 patients with urothelial carcinoma of the bladder and 40 studies including 39,759 patients with upper tract urothelial carcinoma were included in this review and meta-analysis.

Female patients with urothelial carcinoma of the bladder appeared to have worse cancer-specific survival (pooled hazard ratio [HR], 1.20, 95 percent confidence interval [CI], 1.10–1.31), overall survival (pooled HR, 1.03, 95 percent CI, 1.01–1.05), and recurrence-free survival (pooled HR, 1.13, 95 percent CI, 1.02–1.25).

On the other hand, those with upper tract urothelial carcinoma did not appear to have poorer cancer-specific survival (pooled HR, 0.94, 95 percent CI, 0.89–1.00), overall survival (pooled HR, 0.98, 95 percent CI, 0.95–1.01), and recurrence-free survival (pooled HR, 0.90, 95 percent CI, 0.78–1.03).

“Given the genetic and social differences between the sexes, sex differences may represent a key factor in the clinical decision-making process,” the investigators said.

J Urol 2020;204:58-62