Bladder Cancer Death Risk May No Longer Be Higher in Women
PARIS—Previous research has shown that cancer-specific survival (CSS) after radical cystectomy for bladder cancer is significantly worse for women than men, but new data presented at the 27th Annual Congress of the European Association of Urology suggest that this may no longer be the case.
In a retrospective study of 2,483 patients who underwent radical cystectomy for urothelial bladder carcinoma (UBC) from 1989 to 2008, Wolfgang Otto, MD, of the Department of Urology at Regensburg University in Regensburg, and colleagues found that, consistent with previous studies, CSS was significantly worse in women than men. Overall, two-, five-, and eight-year CCS was 59%, 56%, and 45%, respectively, for women compared with 76%, 69%, and 65% for men.
However, when Dr. Otto's team examined the effect of gender on CSS according to three time periods during which patients were treated—1989 to 1996, 1997 to 2002, and 2003 to 2008—they found that CSS was significantly worse for women than men only for those treated in the period 1989 to 1996. For patients treated during this period, women were at 84% greater risk of death than men after adjusting for multiple variables.
The improved CCS in women could be the result of increased physician awareness of bladder cancer in women, leading to earlier diagnosis and treatment, according to Dr. Otto, who reported that the proportion of women treated with radical cystectomy for UBC increased significantly over the three time periods.