Women who underwent radical cystectomy for bladder cancer had a small but significant increase in risk of disease recurrence and cancer-related mortality compared with male patients, even after adjustment for clinical and pathologic factors and competing risk of non–cancer-related death, researchers reported in the April issue of Urology.
Women were 1.16 times more likely to have their bladder cancer recur (P = .03) and 1.27 times more likely to die of cancer-related causes (P = .007), compared with men, reported Dr. Jamie C. Messer of the University of Louisville (Ky.) and his associates.
"Our findings support observations of others that women have a worse survival than men among patients with bladder cancer despite adjustment for stage," the investigators wrote (Urology 2014;83:863-8).
Prior studies have reported 5-year bladder cancer survival rates of 73.1% for women vs. 79.5% for men. To further explore the association, the investigators conducted an international, observational cohort analysis of retrospective data from 4,296 patients who underwent radical cystectomy for advanced bladder cancer. In all, 21% of patients were women. The investigators found that 33.9% of patients had disease recurrence at a median of 11 months after surgery, and that the recurrence rate was higher for women (36.8%) than men (33.1%). Cancer-specific death rates also were higher for women (33% vs. 27.2%).
"The factors that contribute to this increased risk remain to be determined," the investigators said. They noted that adjuvant chemotherapy was linked to "surprisingly lower" disease-specific survival on multivariable analysis, which could mean that residual confounding affected the model and influenced the association of gender with mortality.
The authors reported that they had no relevant financial interests.