Poli Charlotte, Trétarre Brigitte, Trouche-Sabatier Stéphanie, Foucan Anne-Sophie, Abdo Nicolas, Poinas Grégoire, Azria David, Rébillard Xavier, Iborra François
Department of Urology, Carémeau University Hospital, Nîmes, France.
Hérault cancer registry, Montpellier, France; Center for Epidemiology and Research in Population Health (CERPOP), Toulouse, France.
Fr J Urol. 2025 Jan;35(1):102723. doi: 10.1016/j.fjurol.2024.102723. Epub 2024 Aug 29.
Although men have a higher risk of developing a bladder cancer, women appear to have a poorer prognosis and a more advanced stage at diagnosis. We performed a retrospective population-based study on muscle invasive bladder cancer (MIBC) using data from a cancer registry in a French department to compare overall and specific survival data according to sex.
We included all patients living in the department of Hérault and diagnosed with MIBC between January 1, 2017 and December 12, 2019. Univariable and multivariable analyses were performed on all variables of interest.
We included 124 women and 432 men. There was no significant difference in age or stage at diagnosis according to sex. Squamous cell carcinomas were more common in women (P<0.001). Cystectomy was more frequent in men than in women (50.7% vs 35.4%) (P=0.0039). By multivariable analysis, the independent factors for being treated by cystectomy were sex (P=0.004), age (P<0.001) and stage (P<0.001). Forty-seven percent of women received no treatment or palliative treatment. Overall mortality was 79% in women and 63.2% in men (P<0.001). The median specific survival was 10.8months in women and 32.7months in men (P<0.0001). By multivariable analysis, the independent risk factors for mortality were female sex (P=0.047), cT4 stage (P=0.005) and absence of cystectomy (P<0.001).
Our study shows that women are less often treated with cystectomy and have worse prognosis than men. The reasons for this gender difference are multifactorial.
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尽管男性患膀胱癌的风险更高，但女性的预后似乎更差，且诊断时分期更晚。我们利用法国某省癌症登记处的数据，对肌层浸润性膀胱癌（MIBC）进行了一项基于人群的回顾性研究，以比较不同性别的总生存数据和特定生存数据。
我们纳入了所有居住在埃罗省且在2017年1月1日至2019年12月12日期间被诊断为MIBC的患者。对所有感兴趣的变量进行了单变量和多变量分析。
我们纳入了124名女性和432名男性。根据性别，诊断时的年龄或分期无显著差异。女性鳞状细胞癌更为常见（P<0.001）。男性膀胱切除术的频率高于女性（50.7%对35.4%）（P=0.0039）。通过多变量分析，接受膀胱切除术治疗的独立因素为性别（P=0.004）、年龄（P<0.001）和分期（P<0.001）。47%的女性未接受治疗或仅接受了姑息治疗。女性的总死亡率为79%，男性为63.2%（P<0.001）。女性的中位特定生存期为10.8个月，男性为32.7个月（P<0.0001）。通过多变量分析，死亡的独立危险因素为女性性别（P=0.047）、cT4分期（P=0.005）和未进行膀胱切除术（P<0.001）。
我们的研究表明，女性接受膀胱切除术的频率低于男性，且预后比男性更差。这种性别差异的原因是多因素的。
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