Women younger than 59 years are less likely than men to die from renal cell carcinoma (RCC), a newly published study shows.
The study, led by Allan J. Pantuck, MD, Professor of Urology at the David Geffen School of Medicine at the University of California-Los Angeles, included 5,654 RCC patients—3,777 (67%) men and 1,877 (33%) women. Clear-cell RCC occurred significantly more frequently women than men (87% vs. 82%), whereas papillary RCC occurred significantly less common in women (7% vs. 12%). Overall, women had a significant 19% decreased risk of RCC-specific death compared with men, researchers reported online ahead of print in Urologic Oncology.
This survival advantage was limited to women younger than 59 years and was greatest among women younger than 42 years. The five-year disease-specific survival (DSS) rates were 84% and 70% for women and men younger than 42 years, respectively, and 73% and 66%, respectively, among patients in the age group 42-58 years.
The results showed that, as a group, women present with lower-grade and less advanced tumors than men, leading to a decreased risk of cancer-specific death compared with men. “Because this gender-based survival difference is not related to pathologic features, the role of hormonal effects on the development and progression of RCC needs to be investigated,” the authors concluded.
Additionally, the study found that age is an independent predictor of DSS among women, but not men. The risk of cancer-specific death increased by about 1% with each one-year increment in age.
Previous studies have shown that women have a survival advantage compared with men across many tumor types, and whether these survival differences reflect biologic or cultural factors, or both, remains controversial. If the survival differences are due to biologic factors, according to the researchers, a potential mechanism to consider would be the possible protective effect of sex hormones on oncologic processes.
“If a true beneficial effect of hormone status on RCC does exist,” the investigators wrote, “then the potential for therapy targeting the endocrine axis in women would also need to be investigated.”