Effect of sex on prognosis of urothelial carcinoma: Propensity score matching analysis

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Abstract

Background The aim of the present study was to evaluate the effect of differences between the sexes on the prognosis of urothelial carcinoma after adjusting for other factors by using propensity score matching. Patients and Methods Between 2000 and 2011, 678 consecutive patients who had undergone radical cystectomy or radical nephroureterectomy for urothelial carcinoma were enrolled in this study. Propensity score methodology was used to adjust for selection bias with 10 and 12 perioperative variables for urothelial carcinoma of the bladder (UCB) and upper tract urothelial carcinoma (UTUC). By a 2:1 male-to-female patient matching ratio, we selected 38 and 66 pairs of patients with UCB and UTUC. Results The number of male patients was 573 (84.5%), and there were 105 female patients (15.5%). The mean follow-up was 55.5 ± 38.4 months. There were no significant differences in the perioperative variables of age, pathologic T (pT) stage, grade, lymphovascular invasion (LVI), and concomitant carcinoma in situ (CIS) between the sexes. Neither cancer-specific survival (CSS) or overall survival (OS) was associated with sex in a multivariate Cox proportional hazard model. In propensity score matching analysis, female sex was not an independent risk factor for CSS and OS in urothelial carcinoma. In patients with UCB, body mass index (BMI) and pT stage were independently associated with CCS. For the patients with UTUC, age, pT stage, LVI, adjuvant chemotherapy, bladder cuffing, and location were significantly correlated. Conclusion After adjusting for other risk factors with propensity score matching, female sex may not be an independent risk factor in prognosis for urothelial carcinoma (UC).

Original languageEnglish
Pages (from-to)e113-e121
JournalClinical Genitourinary Cancer
Volume13
Issue number2
DOIs
StatePublished - 1 Apr 2015

Keywords

  • Carcinoma
  • Prognosis
  • Sex
  • Transitional cell
  • Urinary bladder neoplasm
  • Urinary tract
  • Urothelium

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