Among patients with high-risk nonmuscle-invasive bladder cancer, women have worse oncologic outcomes compared with men, according to data presented at the 36th annual European Association of Urology (EAU) congress.

The data are from a study of 3255 patients with pTa bladder cancer, 696 (21%) of whom were women. Men and women showed no statistically significant difference in pathologic features such as tumor grade and size and concomitant carcinoma in situ.

During a median follow-up duration of 69.9 months, 1502 patients had recurrence of disease following treatment, 312 had progression to stage pT1 cancer or higher, and 221 had progression to stage pT2 or higher, first author Ivan Lysenko, MD, of the Medical University of Vienna in Vienna, Austria, reported. On univariable Cox regression analysis, sex was not associated with recurrence-free or progression-free survival.

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Among patients with high-risk disease based on EAU risk-stratification criteria, however, female sex was significantly associated with 3.5-fold and 6.7-fold increased odds of progression to pT1 or higher and pT2 or higher disease, respectively. Age of menopause, which the investigators arbitrarily defined as age 50 years, was not associated with oncologic outcomes. They found no association of sex with response to adjuvant intravesical therapy.

These findings could help in clinical decision-making, tailoring a personalized follow-up schedule, and early identification of patients who will eventually fail adjuvant intravesical therapy, Dr Lysenko reported.


Lysenko I, D’andrea D, Moschini M, et al. Association of sex with oncologic outcomes in pTa bladder cancer. Presented at: EAU 2021, held July 8-12, 2021. Abstract P0737.