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Gender and Mortality after Radical Cystectomy: Competing Risk Analysis
Ulrike Heberling1, Rainer Koch2, Matthias Hübler3
1Departments of Urology, Dresden, Germany.
Urologia Internationalis
|September 3, 2018
Summary
Female gender did not predict bladder cancer mortality after radical cystectomy, despite increased risk of extravesical disease. Anatomical differences may explain outcomes in patients undergoing bladder cancer surgery.
Area of Science:
- Urology
- Oncology
- Medical Statistics
Background:
- Conflicting data exists on gender's impact on mortality following radical cystectomy.
- This study addresses the relationship between gender and outcomes in a large, single-center cohort with long-term follow-up.
Purpose of the Study:
- To investigate the association between gender and mortality after radical cystectomy.
- To determine if gender influences the risk of bladder cancer-specific mortality and other competing risks.
Main Methods:
- Analysis of 1,184 consecutive patients undergoing radical cystectomy for bladder cancer (1993-2015).
- Stratification by gender and comparison of demographic data.
- Utilized Cox proportional hazard models for competing risks and logit models for chemotherapy prediction.
Main Results:
- Female patients were older, healthier, less likely to smoke, and had more extravesical tumors.
- Female gender independently predicted lower non-bladder cancer mortality (HR 0.68, p=0.0248).
- Female gender did not predict bladder cancer-specific mortality (HR 1.20, p=0.15) or receipt of chemotherapy.
Conclusions:
- Female gender is linked to increased risk of extravesical disease but not bladder cancer-specific mortality post-cystectomy.
- Potential anatomical differences between genders may explain observed outcomes.
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