Evidence-based Sex-related Outcomes After Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: Results of Large Multicenter Study

Fernández, Mario; Shariat, Shahrokh F.; Margulis, Vitaly; Bolenz, Christian; Montorsi, Francesco; Suardi, Nazareno; Remzi, Mesut; Wood, Christopher G.; Roscigno, Marco; Kikuchi, Eiji; Oya, Mototsugu; Zigeuner, Richard; Langner, Cord; Weizer, Alon Z.; Lotan, Yair; Koppie, Theresa M.; Raman, Jay D.; Karakiewizc, Pierre; Bensalah, Karim; Schultz, Marcela; Bernier, Pablo A.

doi:10.1016/j.urology.2008.07.042

Cited by 79 publications

(55 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite these diVerences between genders, this study conWrms previous studies showing that there is no diVerence in outcomes between men and women treated with radical nephroureterectomy for upper tract urothelial carcinoma [6,7]. With regard to the lower urinary tract, Fajkovic has summarized the most recent Wndings on this topic in an excellent review with literature search going back more than 35 years.…”

supporting

confidence: 84%

Urothelial carcinoma

Merseburger

Shariat

2011

World J Urol

Self Cite

View full text Add to dashboard Cite

supporting

confidence: 84%

Urothelial carcinoma

Merseburger

Shariat

2011

World J Urol

Self Cite

View full text Add to dashboard Cite

“…In patients with heavy long-term cumulative smoking exposure, female gender remained an independent risk factor for both endpoints in multivariable analyses. This finding is of particular importance since previous studies have not found differences in outcomes between men and women treated with RNU for UTUC [9][10][11]. Although there is no comparable study in UTUC, a previous study in urothelial carcinoma of the bladder found poor outcomes in smokers, particularly in male patients in univariable analysis [32].…”

Section: Discussionmentioning

confidence: 78%

“…Yet, although men have been estimated to be more than twice as likely to develop UTUC than women, there is no difference between genders with regard to prognosis after adjusting for tumour stage [9][10][11]. In lower tract urothelial carcinoma (i.e.…”

Section: Introductionmentioning

confidence: 99%

Gender‐specific effect of smoking on upper tract urothelial carcinoma outcomes

et al. 2013

Self Cite

View full text Add to dashboard Cite

Objective• To evaluate the gender-specific differential effects of smoking habits and cumulative smoking exposure on outcomes in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). Patients and Methods• A total of 864 consecutive patients, comprising 553 (64%) men and 311 (36%) women, from five international institutions underwent RNU without neoadjuvant chemotherapy.• Smoking history included smoking status (current, former or never), quantity of cigarettes per day (CPD), smoking duration in years and years since smoking cessation. Cumulative smoking exposure was categorized as light short-term (Յ19 CPD and Յ19.9 years), moderate (all combinations except light short-term and heavy long-term), and heavy long-term (Ն20 CPD and Ն20 years).• Uni-and multivariable competing risk regression models were used to assess the associations with outcomes. Results• Overall, 244 (28.2%), 297 (34.4%) and 323 (37.4%) patients were never, former and current smokers, respectively.• There were no differences in smoking status, quantity and duration between the genders.• In female ever smokers, 30 (9.6%), 121 (38.9%) and 67 (21.5%) were light short-term, moderate and heavy long-term smokers, respectively. Compared with men, female current smokers were more likely to experience disease recurrence in univariable analysis (P = 0.013).• In heavy long-term smokers, female gender was significantly associated with disease recurrence (hazard ratio [HR] 1.7; P = 0.03) and cancer-specific mortality (HR 2.0; P = 0.009) in multivariable analysis that adjusted for standard clinico-pathological features.• In female patients only, smoking quantity, duration and cumulative exposure were associated with disease recurrence and cancer-specific mortality on multivariable analyses (P Յ 0.025). Conclusions• The impact of smoking on UTUC outcomes after RNU is gender-specific.• Females who are current and heavy long-term smokers experience worse outcomes than their male counterparts. • Further research is needed to elucidate the molecular mechanisms underlying the gender-specific differential effect of smoking on UTUC outcomes.

show abstract

“…In the current guidelines, gender alone is no longer considered an independent prognostic factor that influences CSS, in contrast to remarks concerning patient age in UTUC treated surgically (1,4,14). Using the largest retrospective cohort of UTUCs, Shariat et al (15) reported that older age was independently associated with CSS, but not disease recurrence, after controlling for the effects of standard pathological features of RNU specimens.…”

Section: Discussionmentioning

confidence: 99%

Patient age was an independent predictor of cancer-specific survival in male patients with upper tract urothelial carcinoma treated by radical nephroureterectomy

Kobayashi

Kikuchi

Tanaka

et al. 2016

Japanese Journal of Clinical Oncology

Self Cite

View full text Add to dashboard Cite

Objective: We hypothesized that there may be a prognostic difference in age between the genders and evaluated the influence of gender-adjusted age on prognosis in upper tract urothelial carcinoma patients. Methods: A total of 839 patients with upper tract urothelial carcinoma from a retrospective multiinstitutional cohort were included. The patients were divided into four groups consisting of males (N = 610) and females (N = 229) according to age ((i) <60 years, (ii) 60-69.9 years, (iii) 70-79.9 years and (iv) ≥80 years), and we evaluated the associations of patient age and gender with clinicopathological features and oncological outcomes following radical nephroureterectomy. The median follow-up duration was 34 months. Results: Disease recurrence occurred in 249 patients and 192 patients died of upper tract urothelial carcinoma. The 3-year cancer-specific survival rates were (i) 84.3%, (ii) 80.2%, (iii) 77.1% and (iv) 71.5% in the entire patient population (P = 0.001); (i) 84.5%, (ii) 81.1%, (iii) 76.8% and (iv) 69.7% in males (P = 0.010); and (i) 83.3%, (ii) 76.9%, (iii) 77.7% and (iv) 72.9% in females (P = 0.287), respectively. No significant differences between disease recurrence and age were found in the male or female population. In multivariate analysis, older age was an independent predictor of cancer-specific survival, in addition to advanced pT stage, the presence of lymphovascular invasion and lymph node involvement in males. In contrast, age was not associated with cancer-specific survival in females, while high grade, advanced pT stage, the presence of lymph node involvement and multifocal tumor were independent predictors. Conclusion: The results indicate that gender-adjusted age might be a new prognostic factor in upper tract urothelial carcinoma patients.

show abstract

Evidence-based Sex-related Outcomes After Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: Results of Large Multicenter Study

Cited by 79 publications

References 17 publications

Urothelial carcinoma

Urothelial carcinoma

Gender‐specific effect of smoking on upper tract urothelial carcinoma outcomes

Patient age was an independent predictor of cancer-specific survival in male patients with upper tract urothelial carcinoma treated by radical nephroureterectomy

Contact Info

Product

Resources

About