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Treatment according to guidelines may bridge the gender gap in outcome for patients with stage T1 urinary bladder cancer

Sjöström, Carin; Thorstenson, Andreas; Ströck, Viveka; Hosseini-Aliabad, Abolfazl; Aljabery, Firas; Liedberg, Fredrik LU ; Sherif, Amir; Malmström, Per Uno; Rosell, Johan and Gårdmark, Truls, et al. (2018) In Scandinavian Journal of Urology 52(3). p.186-193
Abstract

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... (More)

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.

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published
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keywords
Bladder cancer, female, gender, intravesical instillation therapy, male, population-based, survival
in
Scandinavian Journal of Urology
volume
52
issue
3
pages
186 - 193
publisher
Taylor & Francis
external identifiers
  • scopus:85045740967
ISSN
2168-1805
DOI
10.1080/21681805.2018.1462254
language
English
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yes
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f08f2907-c275-4843-b9b0-02012774014f
date added to LUP
2018-05-02 15:08:59
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2019-01-14 14:29:07
@article{f08f2907-c275-4843-b9b0-02012774014f,
  abstract     = {<p>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 &lt; .001). A larger proportion of males than females underwent intravesical instillation therapy (39% vs 33%, p &lt; .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.</p>},
  author       = {Sjöström, Carin and Thorstenson, Andreas and Ströck, Viveka and Hosseini-Aliabad, Abolfazl and Aljabery, Firas and Liedberg, Fredrik and Sherif, Amir and Malmström, Per Uno and Rosell, Johan and Gårdmark, Truls and Jahnson, Staffan},
  issn         = {2168-1805},
  keyword      = {Bladder cancer,female,gender,intravesical instillation therapy,male,population-based,survival},
  language     = {eng},
  month        = {04},
  number       = {3},
  pages        = {186--193},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology},
  title        = {Treatment according to guidelines may bridge the gender gap in outcome for patients with stage T1 urinary bladder cancer},
  url          = {http://dx.doi.org/10.1080/21681805.2018.1462254},
  volume       = {52},
  year         = {2018},
}