Puente D, Malats N, Cecchini L, Tardón A, García-Closas R, Serra C, Carrato A, Sala M, Boixeda R, Dosemeci M, Real F X, Kogevinas M
Institut Municipal d'Investigació Mèdica, Universitat Pompeu Fabra, Carrer del Dr. Aiguader 80, E-08003, Barcelona, Spain.
Eur Urol. 2003 Jan;43(1):53-62. doi: 10.1016/s0302-2838(02)00496-7.
To confirm the very high male:female ratios previously observed among Spanish bladder cancer patients and to assess gender differences in tumoral characteristics, diagnostic procedures, and treatment in a large series of consecutive bladder cancer patients.
All newly diagnosed bladder cancer patients (n=615) in 17 Spanish hospitals, between 1997-2000, were included. Information was collected both through personal interviews to patients and from medical records using a structured form.
Seventy-six percent of tumours were superficial. The male:female ratio was 6.7 and it was similar for superficial and infiltrating tumours. Women were older than men at the diagnosis of bladder cancer (68.2+/-9.4 years versus 65.7+/-9.7 years, p=0.01). Ten percent of superficial tumours in women, versus 3% in men, were classified as "other histological types" (p=0.008). T1GIII tumours were more frequent among men (17% versus 7%, p=0.047). On the other hand, women were more likely to present with 0a-stage tumours (48.6% versus 35.5%, p=0.04), multiple tumours (50% versus 29%, trend test: 0.005), multi-centric tumours (54% versus 38%, p=0.019), and larger infiltrating masses (5.2 cm versus 3.8 cm, p=0.03) than men. Among 0a-stage tumours, only 23% of women compared to 54% of men received transurethral resection (TUR) alone (p=0.002). Women were almost five-fold more likely to receive additional therapies to TUR (p=0.004) after adjusting for age, geographical area, stage, tumoral size, nuclear grade, and multiplicity.
The study confirms the very high male:female ratio of bladder cancer in Spain. We found substantial differences in the pathological characteristics of tumours from men and women. There was a tendency for women to receive more frequently non-standard, more aggressive, therapy than men.
证实先前在西班牙膀胱癌患者中观察到的极高的男女比例，并在一大系列连续的膀胱癌患者中评估肿瘤特征、诊断程序及治疗方面的性别差异。
纳入了1997年至2000年间西班牙17家医院所有新诊断的膀胱癌患者（n = 615）。通过对患者进行个人访谈以及使用结构化表格从病历中收集信息。
76%的肿瘤为浅表性肿瘤。男女比例为6.7，浅表性肿瘤和浸润性肿瘤的该比例相似。膀胱癌诊断时女性比男性年龄大（68.2±9.4岁对65.7±9.7岁，p = 0.01）。女性浅表性肿瘤中有10%被归类为“其他组织学类型”，而男性为3%（p = 0.008）。T1GIII期肿瘤在男性中更常见（17%对7%，p = 0.047）。另一方面，女性比男性更易出现0a期肿瘤（48.6%对35.5%，p = 0.04）、多发肿瘤（50%对29%，趋势检验：0.005）、多中心肿瘤（54%对38%，p = 0.019）以及更大的浸润性肿块（5.2厘米对3.8厘米，p = 0.03）。在0a期肿瘤中，仅23%的女性接受单纯经尿道切除术（TUR），而男性为54%（p = 0.002）。在对年龄、地理区域、分期、肿瘤大小、核分级和多发性进行调整后，女性接受TUR后接受额外治疗的可能性几乎是男性的五倍（p = 0.004）。
该研究证实了西班牙膀胱癌极高的男女比例。我们发现男性和女性肿瘤的病理特征存在显著差异。女性比男性更倾向于接受更频繁的非标准、更积极的治疗。
