Department of Urology, Osaka International Cancer Institute, Osaka, Japan.
Department of Medical Statistics, Research & Development Center, Osaka Medical College, Osaka, Japan.
Int J Urol. 2019 Jun;26(6):649-654. doi: 10.1111/iju.13955. Epub 2019 Mar 27.
To investigate the impact of sex on the prognosis of bladder cancer in Japan.
In total, 18 728 patients diagnosed as having bladder cancer from 1993 to 2006 were registered in population-based cancer registries of six prefectures in Japan. We estimated relative survival by sex, age, clinical stage at initial diagnosis and pathology.
Patients included 14 203 men (75.8%) and 4525 women (24.2%). The stage at initial diagnosis in women was significantly higher than in men (P < 0.0001). Pathologically, women were more likely to have non-urothelial cancer than men (women 18.0%, men 9.5%, P < 0.0001). The 5-year relative survival was 80.3% for men and 67.7% for women. The 5-year relative survival was 93.0% for men and 87.7% for women in the localized cancer group, 34.8% for men and 23.9% for women in the locally advanced cancer group, and 7.1% for men and 8.3% for women in the metastatic cancer group. The relative survival of women was worse than that of men in the localized cancer group (hazard ratio 1.29, 95% confidence interval 1.05-1.57; P = 0.0145) and locally advanced cancer group (hazard ratio 1.32, 95% confidence interval 1.15-1.52; P = 0.0001), but not different in the metastatic cancer group (hazard ratio 1.04, 95% confidence interval 0.87-1.25; P = 0.6555).
Population-based registry data in Japan show that the cancer stage at initial diagnosis is higher in women than in men, and women with localized or locally advanced bladder cancer have a worse prognosis compared with men.
探讨性别对日本膀胱癌预后的影响。
从日本六个县的基于人群的癌症登记处共登记了 1993 年至 2006 年间诊断为膀胱癌的 18728 例患者。我们按性别、年龄、初诊时临床分期和病理对相对生存率进行了估计。
患者中男性 14203 例（75.8%），女性 4525 例（24.2%）。女性初诊时的分期明显高于男性（P<0.0001）。病理上，女性非尿路上皮癌的比例高于男性（女性 18.0%，男性 9.5%，P<0.0001）。男性的 5 年相对生存率为 80.3%，女性为 67.7%。局限期癌症患者中，男性和女性的 5 年相对生存率分别为 93.0%和 87.7%；局部进展期癌症患者中，男性和女性分别为 34.8%和 23.9%；转移性癌症患者中，男性和女性分别为 7.1%和 8.3%。局限期癌症组（危险比 1.29，95%置信区间 1.05-1.57；P=0.0145）和局部进展期癌症组（危险比 1.32，95%置信区间 1.15-1.52；P=0.0001）中女性的相对生存率差于男性，但在转移性癌症组中无差异（危险比 1.04，95%置信区间 0.87-1.25；P=0.6555）。
日本基于人群的登记处数据显示，女性初诊时的癌症分期高于男性，且局限期或局部进展期膀胱癌女性的预后较男性差。
