Patafio Francis Michael, Robert Siemens D, Wei Xuejiao, Booth Christopher M
Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Queen's University, Kingston, ON;
Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Queen's University, Kingston, ON; ; Department of Oncology, Queen's University, Kingston, ON; ; Department of Urology, Queen's University, Kingston, ON;
Can Urol Assoc J. 2015 Jul-Aug;9(7-8):269-74. doi: 10.5489/cuaj.2927.
The incidence of bladder cancer varies by gender. Whether differences exist between women and men in extent of disease, treatment, and outcome is not well-described. We evaluate gender differences in bladder cancer using a population-based cohort.
Electronic records of treatment were linked to the population-based Ontario Cancer Registry to identify all patients with bladder cancer treated with cystectomy or radical radiotherapy (RT) in Ontario between 1994 and 2008. We compare extent of disease at time of cystectomy, treatment, and outcomes between women and men.
In total, 5259 patients with bladder cancer were treated with cystectomy or radical RT; of these, 25% (n = 1296) were women. There was no gender difference in the proportion of patients treated with cystectomy (75% of women [974/1296], 73% of men [2905/3963], p = 0.189). At the time of cystectomy, women were more likely to have muscle-invasive disease (86% [836/974] vs. 80% [2335/2905], p < 0.001), but less likely to have lymph nodes dissected (68% [664/974] vs. 76% [2210/2905], p < 0.001]. Among the 2944 patients with muscle-invasive urothelial carcinoma treated with cystectomy, use of neoadjuvant (5% vs. 4%, p = 0.419) and adjuvant chemotherapy (18% vs. 20%, p = 0.190) did not differ significantly between genders. Five-year cancer-specific survival and overall survival of the full cohort did not differ between women and men (38% vs. 39%, p = 0.522; 33% vs. 33%, p = 0.795).
This population-based cohort did not demonstrate any substantial differences in extent of disease, treatment, or outcome between women and men treated with cystectomy or radical RT for bladder cancer.
膀胱癌的发病率因性别而异。关于女性和男性在疾病范围、治疗及预后方面是否存在差异，目前尚无详尽描述。我们使用基于人群的队列研究来评估膀胱癌的性别差异。
将治疗的电子记录与基于人群的安大略癌症登记处相链接，以识别1994年至2008年间在安大略接受膀胱切除术或根治性放疗（RT）的所有膀胱癌患者。我们比较了女性和男性膀胱切除时的疾病范围、治疗情况及预后。
共有5259例膀胱癌患者接受了膀胱切除术或根治性放疗；其中，25%（n = 1296）为女性。接受膀胱切除术的患者比例在性别上无差异（女性为75%[974/1296]，男性为73%[2905/3963]，p = 0.189）。在膀胱切除时，女性更易出现肌层浸润性疾病（86%[836/974]对80%[2335/2905]，p < 0.001），但进行淋巴结清扫的可能性较小（68%[664/974]对76%[2210/2905]，p < 0.001）。在2944例接受膀胱切除术的肌层浸润性尿路上皮癌患者中，新辅助化疗（5%对4%，p = 0.419）和辅助化疗（18%对20%，p = 0.190）在性别上无显著差异。整个队列的五年癌症特异性生存率和总生存率在女性和男性之间无差异（38%对39%，p = 0.522；33%对33%，p = 0.795）。
该基于人群的队列研究未显示接受膀胱切除术或根治性放疗的膀胱癌女性和男性在疾病范围、治疗或预后方面存在任何实质性差异。
