TY - JOUR
T1 - Treatment according to guidelines may bridge the gender gap in outcome for patients with stage T1 urinary bladder cancer
AU - Sjöström, Carin
AU - Thorstenson, Andreas
AU - Ströck, Viveka
AU - Hosseini-Aliabad, Abolfazl
AU - Aljabery, Firas
AU - Liedberg, Fredrik
AU - Sherif, Amir
AU - Malmström, Per Uno
AU - Rosell, Johan
AU - Gårdmark, Truls
AU - Jahnson, Staffan
PY - 2018
Y1 - 2018
N2 - Objective: The aim of this investigation was to study differences between male and female patients with stage T1 urinary bladder cancer (UBC) regarding intravesical instillation therapy, second resection and survival. Materials and methods: This study included all patients with non-metastatic primary T1 UBC reported to the Swedish National Register of Urinary Bladder Cancer (SNRUBC) from 1997 to 2014, excluding those treated with primary cystectomy. Differences between groups were evaluated using chi-squared tests and logistic regression, and survival was investigated using Kaplan–Meier and log-rank tests and Cox proportional hazards analysis. Results: In all, 7681 patients with T1 UBC (77% male, 23% female) were included. Females were older than males at the time of diagnosis (median age at presentation 76 and 74 years, respectively; p < .001). A larger proportion of males than females underwent intravesical instillation therapy (39% vs 33%, p < .001). Relative survival was lower in women aged ≥75 years and women with G3 tumours compared to men. However, women aged ≥75 years who had T1G3 tumours and underwent second resection followed by intravesical instillation therapy showed a relative survival equal to that observed in men. Conclusions: This population-based study demonstrates that women of all ages with T1 UBC undergo intravesical instillation therapy less frequently than men, and that relative survival is poorer in women aged ≥75 years than in men of the same age when intravesical instillation therapy and second resection are not used. However, these disparities may disappear with treatment according to guidelines.
AB - Objective: The aim of this investigation was to study differences between male and female patients with stage T1 urinary bladder cancer (UBC) regarding intravesical instillation therapy, second resection and survival. Materials and methods: This study included all patients with non-metastatic primary T1 UBC reported to the Swedish National Register of Urinary Bladder Cancer (SNRUBC) from 1997 to 2014, excluding those treated with primary cystectomy. Differences between groups were evaluated using chi-squared tests and logistic regression, and survival was investigated using Kaplan–Meier and log-rank tests and Cox proportional hazards analysis. Results: In all, 7681 patients with T1 UBC (77% male, 23% female) were included. Females were older than males at the time of diagnosis (median age at presentation 76 and 74 years, respectively; p < .001). A larger proportion of males than females underwent intravesical instillation therapy (39% vs 33%, p < .001). Relative survival was lower in women aged ≥75 years and women with G3 tumours compared to men. However, women aged ≥75 years who had T1G3 tumours and underwent second resection followed by intravesical instillation therapy showed a relative survival equal to that observed in men. Conclusions: This population-based study demonstrates that women of all ages with T1 UBC undergo intravesical instillation therapy less frequently than men, and that relative survival is poorer in women aged ≥75 years than in men of the same age when intravesical instillation therapy and second resection are not used. However, these disparities may disappear with treatment according to guidelines.
KW - Bladder cancer
KW - female
KW - gender
KW - intravesical instillation therapy
KW - male
KW - population-based
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=85045740967&partnerID=8YFLogxK
U2 - 10.1080/21681805.2018.1462254
DO - 10.1080/21681805.2018.1462254
M3 - Article
C2 - 29676191
AN - SCOPUS:85045740967
SN - 2168-1805
VL - 52
SP - 186
EP - 193
JO - Scandinavian Journal of Urology
JF - Scandinavian Journal of Urology
IS - 3
ER -