Gender-specific survival following radical cystectomy for pT4 bladder cancer

Dharam Kaushik, Igor Frank, Manuel S. Eisenberg, John C. Cheville, Robert Tarrell, Prabin Thapa, R. Houston Thompson, Stephen A. Boorjian

Research output: Contribution to journalArticle

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Abstract

Purpose: To evaluate the association of gender with survival following radical cystectomy (RC) for patients with pT4 bladder cancer.

Materials and methods: We reviewed our institutional registry of 2,088 patients treated with RC between 1980 and 2005 to identify 128 with pT4 tumors, including 91 males and 37 females. Survival was estimated using the Kaplan–Meier method and compared with log-rank test. Cox hazard regression models were used to analyze the association of clinicopathologic demographics, including gender, with outcome.

Results: A total of 7 women and 30 men with pT4 tumor received perioperative chemotherapy. Median postoperative follow-up was 10.5 years, during which time 27 patients experienced local recurrence (LR) and 120 died, including 90 who died from bladder cancer. Women with pT4 tumor trended to have higher 5-year LR-free survival (72 vs. 59 %; p = 0.83), cancer-specific survival (31 vs. 17 %; p = 0.50), and overall survival (19 vs. 11 %; p = 0.33), although these differences did not reach statistical significance. On multivariate analysis, moreover, gender was not significantly associated with LR (HR 0.96; p = 0.93), cancer-specific mortality (HR 1.05; p = 0.87), or all-cause mortality (ACM) (HR 1.14; p = 0.58). Instead, poor ECOG performance status and pN+ disease were associated with an increased risk of ACM, while removal of a greater number of lymph nodes was associated with decreased ACM.

Conclusion: We did not find gender-specific disparities in survival following RC for pT4 bladder cancer. Prognosis was instead driven by patient performance status and lymph node status.

Original languageEnglish (US)
Pages (from-to)1433-1439
Number of pages7
JournalWorld Journal of Urology
Volume32
Issue number6
DOIs
StatePublished - Nov 19 2014

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Cystectomy
Urinary Bladder Neoplasms
Survival
Mortality
Neoplasms
Recurrence
Lymph Nodes
Proportional Hazards Models
Registries
Multivariate Analysis
Demography
Drug Therapy

Keywords

  • Bladder cancer
  • Cancer-specific survival
  • Overall survival
  • Radical cystectomy

ASJC Scopus subject areas

  • Urology

Cite this

Kaushik, D., Frank, I., Eisenberg, M. S., Cheville, J. C., Tarrell, R., Thapa, P., ... Boorjian, S. A. (2014). Gender-specific survival following radical cystectomy for pT4 bladder cancer. World Journal of Urology, 32(6), 1433-1439. https://doi.org/10.1007/s00345-013-1232-y

Gender-specific survival following radical cystectomy for pT4 bladder cancer. / Kaushik, Dharam; Frank, Igor; Eisenberg, Manuel S.; Cheville, John C.; Tarrell, Robert; Thapa, Prabin; Thompson, R. Houston; Boorjian, Stephen A.

In: World Journal of Urology, Vol. 32, No. 6, 19.11.2014, p. 1433-1439.

Research output: Contribution to journalArticle

Kaushik, D, Frank, I, Eisenberg, MS, Cheville, JC, Tarrell, R, Thapa, P, Thompson, RH & Boorjian, SA 2014, 'Gender-specific survival following radical cystectomy for pT4 bladder cancer', World Journal of Urology, vol. 32, no. 6, pp. 1433-1439. https://doi.org/10.1007/s00345-013-1232-y
Kaushik D, Frank I, Eisenberg MS, Cheville JC, Tarrell R, Thapa P et al. Gender-specific survival following radical cystectomy for pT4 bladder cancer. World Journal of Urology. 2014 Nov 19;32(6):1433-1439. https://doi.org/10.1007/s00345-013-1232-y
Kaushik, Dharam ; Frank, Igor ; Eisenberg, Manuel S. ; Cheville, John C. ; Tarrell, Robert ; Thapa, Prabin ; Thompson, R. Houston ; Boorjian, Stephen A. / Gender-specific survival following radical cystectomy for pT4 bladder cancer. In: World Journal of Urology. 2014 ; Vol. 32, No. 6. pp. 1433-1439.
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abstract = "Purpose: To evaluate the association of gender with survival following radical cystectomy (RC) for patients with pT4 bladder cancer.Materials and methods: We reviewed our institutional registry of 2,088 patients treated with RC between 1980 and 2005 to identify 128 with pT4 tumors, including 91 males and 37 females. Survival was estimated using the Kaplan–Meier method and compared with log-rank test. Cox hazard regression models were used to analyze the association of clinicopathologic demographics, including gender, with outcome.Results: A total of 7 women and 30 men with pT4 tumor received perioperative chemotherapy. Median postoperative follow-up was 10.5 years, during which time 27 patients experienced local recurrence (LR) and 120 died, including 90 who died from bladder cancer. Women with pT4 tumor trended to have higher 5-year LR-free survival (72 vs. 59 {\%}; p = 0.83), cancer-specific survival (31 vs. 17 {\%}; p = 0.50), and overall survival (19 vs. 11 {\%}; p = 0.33), although these differences did not reach statistical significance. On multivariate analysis, moreover, gender was not significantly associated with LR (HR 0.96; p = 0.93), cancer-specific mortality (HR 1.05; p = 0.87), or all-cause mortality (ACM) (HR 1.14; p = 0.58). Instead, poor ECOG performance status and pN+ disease were associated with an increased risk of ACM, while removal of a greater number of lymph nodes was associated with decreased ACM.Conclusion: We did not find gender-specific disparities in survival following RC for pT4 bladder cancer. Prognosis was instead driven by patient performance status and lymph node status.",
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N2 - Purpose: To evaluate the association of gender with survival following radical cystectomy (RC) for patients with pT4 bladder cancer.Materials and methods: We reviewed our institutional registry of 2,088 patients treated with RC between 1980 and 2005 to identify 128 with pT4 tumors, including 91 males and 37 females. Survival was estimated using the Kaplan–Meier method and compared with log-rank test. Cox hazard regression models were used to analyze the association of clinicopathologic demographics, including gender, with outcome.Results: A total of 7 women and 30 men with pT4 tumor received perioperative chemotherapy. Median postoperative follow-up was 10.5 years, during which time 27 patients experienced local recurrence (LR) and 120 died, including 90 who died from bladder cancer. Women with pT4 tumor trended to have higher 5-year LR-free survival (72 vs. 59 %; p = 0.83), cancer-specific survival (31 vs. 17 %; p = 0.50), and overall survival (19 vs. 11 %; p = 0.33), although these differences did not reach statistical significance. On multivariate analysis, moreover, gender was not significantly associated with LR (HR 0.96; p = 0.93), cancer-specific mortality (HR 1.05; p = 0.87), or all-cause mortality (ACM) (HR 1.14; p = 0.58). Instead, poor ECOG performance status and pN+ disease were associated with an increased risk of ACM, while removal of a greater number of lymph nodes was associated with decreased ACM.Conclusion: We did not find gender-specific disparities in survival following RC for pT4 bladder cancer. Prognosis was instead driven by patient performance status and lymph node status.

AB - Purpose: To evaluate the association of gender with survival following radical cystectomy (RC) for patients with pT4 bladder cancer.Materials and methods: We reviewed our institutional registry of 2,088 patients treated with RC between 1980 and 2005 to identify 128 with pT4 tumors, including 91 males and 37 females. Survival was estimated using the Kaplan–Meier method and compared with log-rank test. Cox hazard regression models were used to analyze the association of clinicopathologic demographics, including gender, with outcome.Results: A total of 7 women and 30 men with pT4 tumor received perioperative chemotherapy. Median postoperative follow-up was 10.5 years, during which time 27 patients experienced local recurrence (LR) and 120 died, including 90 who died from bladder cancer. Women with pT4 tumor trended to have higher 5-year LR-free survival (72 vs. 59 %; p = 0.83), cancer-specific survival (31 vs. 17 %; p = 0.50), and overall survival (19 vs. 11 %; p = 0.33), although these differences did not reach statistical significance. On multivariate analysis, moreover, gender was not significantly associated with LR (HR 0.96; p = 0.93), cancer-specific mortality (HR 1.05; p = 0.87), or all-cause mortality (ACM) (HR 1.14; p = 0.58). Instead, poor ECOG performance status and pN+ disease were associated with an increased risk of ACM, while removal of a greater number of lymph nodes was associated with decreased ACM.Conclusion: We did not find gender-specific disparities in survival following RC for pT4 bladder cancer. Prognosis was instead driven by patient performance status and lymph node status.

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