Gender and cystectomy for bladder cancer: A high-volume tertiary urologic care center experience.


Journal

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
ISSN: 1532-2157
Titre abrégé: Eur J Surg Oncol
Pays: England
ID NLM: 8504356

Informations de publication

Date de publication:
10 2023
Historique:
received: 04 04 2023
revised: 23 07 2023
accepted: 16 08 2023
medline: 2 10 2023
pubmed: 29 8 2023
entrez: 28 8 2023
Statut: ppublish

Résumé

Differences have often been reported in the outcomes of bladder cancer (BC) patients according to gender. This study aims to provide data on patients undergoing radical cystectomy (RC) in a high-volume tertiary urologic center and to assess whether gender discrepancies do exist in terms of surgical options and clinical outcomes. Consecutive BC patients treated between 2016 and 2020 at a single center (Careggi University Hospital, Florence, Italy) were included in the study. The impact of gender on disease stage at diagnosis, overall survival (OS), and type of surgery was analyzed. The study series comprised 447 patients (85 females and 362 males). At a median follow-up of 28.3 months (IQR: 33.5), OS was 52.6% and cancer-specific survival was 67.6%. Significant differences in OS emerged for age, acute myocardial infarction (AMI), Charlson Comorbidity Index (CCI), pT, and pN. OS rates were higher in patients undergoing robot-assisted surgery and in those receiving open orthotopic neobladder (ONB) (p = 0.0001). No statistically significant differences were found between male and female patients regarding surgical offer in any age group, surgical time, early postoperative complications, pathologic stage, and OS. After adjustment for pathologic tumor stage and treatment modalities, female and male patients showed similar oncologic outcomes. Further studies should be undertaken to evaluate functional results in women subjected to RC.

Sections du résumé

BACKGROUND
Differences have often been reported in the outcomes of bladder cancer (BC) patients according to gender.
OBJECTIVE
This study aims to provide data on patients undergoing radical cystectomy (RC) in a high-volume tertiary urologic center and to assess whether gender discrepancies do exist in terms of surgical options and clinical outcomes.
MATERIALS AND METHODS
Consecutive BC patients treated between 2016 and 2020 at a single center (Careggi University Hospital, Florence, Italy) were included in the study. The impact of gender on disease stage at diagnosis, overall survival (OS), and type of surgery was analyzed.
RESULTS
The study series comprised 447 patients (85 females and 362 males). At a median follow-up of 28.3 months (IQR: 33.5), OS was 52.6% and cancer-specific survival was 67.6%. Significant differences in OS emerged for age, acute myocardial infarction (AMI), Charlson Comorbidity Index (CCI), pT, and pN. OS rates were higher in patients undergoing robot-assisted surgery and in those receiving open orthotopic neobladder (ONB) (p = 0.0001). No statistically significant differences were found between male and female patients regarding surgical offer in any age group, surgical time, early postoperative complications, pathologic stage, and OS.
CONCLUSIONS
After adjustment for pathologic tumor stage and treatment modalities, female and male patients showed similar oncologic outcomes. Further studies should be undertaken to evaluate functional results in women subjected to RC.

Identifiants

pubmed: 37639860
pii: S0748-7983(23)00672-8
doi: 10.1016/j.ejso.2023.107034
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

107034

Informations de copyright

© 2023 Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of competing interest All authors declare that there's no financial/personal interest or belief that could affect their objectivity. They also declare that there's no potential competing interests.

Auteurs

A Mariotti (A)

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy. Electronic address: alberto.mariotti@unifi.it.

P Spatafora (P)

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.

F Sessa (F)

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.

C Saieva (C)

Cancer Risk Factors and LifeStyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy.

I C Galli (IC)

Histopathology and Molecular Diagnostics, Careggi Hospital, Florence, Italy.

G Roviello (G)

Department of Health Sciences, University of Florence, Florence, Italy.

L Doni (L)

Department of Health Sciences, University of Florence, Florence, Italy.

C Zaccaro (C)

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.

C Bisegna (C)

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.

F L Conte (FL)

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.

R Mariottini (R)

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.

A Marzocco (A)

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.

L Masieri (L)

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy; Department of Pediatric Surgery, Pediatric Urology Unit, Anna Meyer Children's Hospital, Florence, Italy.

G Vignolini (G)

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.

A Minervini (A)

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.

S Serni (S)

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.

M Carini (M)

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.

G Nesi (G)

Histopathology and Molecular Diagnostics, Careggi Hospital, Florence, Italy.

D Villari (D)

Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.

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