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Female sex tied to worse survival, recurrence in urothelial carcinoma of the bladder

26 Jun 2020
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Sex appears to contribute to cancer-specific mortality, overall mortality, and disease recurrence in urothelial carcinoma of the bladder, with women drawing the short straw, results of a systematic review and meta-analysis have shown.

The investigators searched PubMed, Web of Science, Cochrane Library and Scopus databases in July 2019 according to the Preferred Reporting for Systematic Reviews and Meta-Analyses statement. Studies that compared overall, cancer-specific, and recurrence-free survival in patients with upper tract urothelial carcinoma and urothelial carcinoma of the bladder were eligible for analysis. Meta-analyses were conducted for these outcomes according to sex differences.

Sixty-six studies including a total of 100,389 patients with urothelial carcinoma of the bladder and 40 studies including 39,759 patients with upper tract urothelial carcinoma were included in this review and meta-analysis.

Female patients with urothelial carcinoma of the bladder appeared to have worse cancer-specific survival (pooled hazard ratio [HR], 1.20, 95 percent confidence interval [CI], 1.10–1.31), overall survival (pooled HR, 1.03, 95 percent CI, 1.01–1.05), and recurrence-free survival (pooled HR, 1.13, 95 percent CI, 1.02–1.25).

On the other hand, those with upper tract urothelial carcinoma did not appear to have poorer cancer-specific survival (pooled HR, 0.94, 95 percent CI, 0.89–1.00), overall survival (pooled HR, 0.98, 95 percent CI, 0.95–1.01), and recurrence-free survival (pooled HR, 0.90, 95 percent CI, 0.78–1.03).

“Given the genetic and social differences between the sexes, sex differences may represent a key factor in the clinical decision-making process,” the investigators said.

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