Gender-Specific Differences in Bladder Cancer: A Retrospective Analysis
Gender-Specific Differences in Bladder Cancer: A Retrospective Analysis
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DOI：
10.1016/j.genm.2008.11.002
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发表时间：
2008-12-01
期刊：
影响因子：
--
通讯作者：
Stenzl, Arnulf
中科院分区：
文献类型：
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作者：
Horstmann, Marcus;Witthuhn, Ralf;Stenzl, Arnulf
背景：据报道，男性膀胱癌的发病率高于女性。临床性别差异已被观察到，但还没有得到很好的描述。目的：这项回顾分析进一步考察了男性和女性在膀胱癌的发展和表现方面的临床差异。方法：连续的男性和女性膀胱癌患者在1969-1997年间在一个中心(奥地利因斯布鲁克因斯布鲁克大学医院)接受治疗。比较男性和女性患者在年龄、肿瘤分类、部位和复发方面的特征。采用t检验、X(2)检验和Kaplan-Meier方法进行亚组分析。结果：在1269例患者中，发现肿瘤1.744个。男性与女性膀胱癌发病率之比为2.2：1。男性肿瘤的确诊年龄明显低于女性(平均年龄分别为62岁和67岁；P<；0.001)。在肿瘤的组织学方面，没有观察到性别差异。肌肉侵袭性肿瘤男性多于女性(39.8%vs34.5%；P=NS)。与女性相比，男性的原发肿瘤更具侵袭性(2级，36.6%比28.2%；P<；0.001)，肿瘤复发更具侵袭性(59.0%比57.8%；P=NS)。男性多于女性(43例[3.4%]vs9例[1.8%]；P=0.034)，三角区(246例[19.8%]vs75例[14.90%]；P<；0.001例)，膀胱穹隆或穹隆(128例[10.3%]vs37例[7.4%]；P=0.015)。总体上，膀胱癌的生存率在性别间没有差异；只有在肌肉浸润性肿瘤中，女性的总体生存率低于男性(P=0.022)。结论：膀胱癌的临床性别差异在男性中的发生率高于女性。在这项分析中，女性在被发现时年龄较大，但与男性相比，女性的肿瘤侵袭性和侵袭性较小。然而，患有肌肉侵袭性疾病的女性的总体存活率低于同一亚组中的男性。(Gend Med.2008年；5：385-394)(C)2008年Excerpta Medica Inc.
Background: A higher incidence of bladder cancer has been reported in men compared with women. Clinical gender differences have been observed but are less well described.Objective: This retrospective analysis further examines clinical differences in the development and manifestation of bladder cancer between men and women.Methods: Consecutive male and female patients with bladder cancer treated between 1969 and 1997 at a single center (University Hospital of Innsbruck, Innsbruck, Austria) were included in the Study. Patient characteristics regarding age, tumor classification, localization, and recurrence were compared between male and female patients. Statistical analysis was conducted using the t test, the chi(2) test, and the Kaplan-Meier method, with the log-rank test for subgroup analysis.Results: In the 1269 patients (876 men, 393 women) who were examined, 1.744 tumors were found. The male-to-female bladder cancer incidence ratio was 2.2:1. Tumors were diagnosed at a significantly younger age in men than in women (mean age: 62 years vs 67 years, respectively; P < 0.001). No difference in the histology of tumors was observed between the sexes. Muscle-invasive tumors more frequently occurred in men than in women (39.8% vs 34.5%; P = NS). In men compared with women, primary tumors were more aggressive (grade 2, 36.6% vs 28.2%; P < 0.001) and tumor recurrences were more invasive (59.0% vs 57.8%; P = NS). Tumors were more often located in the urethra in men than in women (43 [3.4%] vs 9 [1.8%]; P = 0.034), the trigonum (246 [19.8%] vs 75 [14.90%]; P < 0.001), and the bladder dome or vault (128 [10.3%] vs 37 [7.4%]; P = 0.015). Generally, no difference in survival rate was observed between the sexes; only in the subgroup of muscle-invasive tumors (n = 455) did women have a worse overall survival rate than did men (P = 0.022).Conclusions: Clinical gender differences in bladder cancer appear to have a higher incidence in men than in women. In this analysis, women were older at the age of detection, but had less-invasive and less-aggressive tumors than did men. However, women with muscle-invasive disease had a worse overall survival rate than did men in the same subset. (Gend Med. 2008;5:385-394) (C) 2008 Excerpta Medica Inc.