Impact of sex on response to neoadjuvant chemotherapy in patients with bladder cancer.
Urol Oncol
; 38(7): 639.e1-639.e9, 2020 07.
Article
em En
| MEDLINE
| ID: mdl-32057595
ABSTRACT
OBJECTIVE:
To assess the effect of patient's sex on response to neoadjuvant chemotherapy (NAC) in patients with clinically nonmetastatic muscle-invasive bladder cancer (MIBC).METHODS:
Complete pathologic response, defined as ypT0N0 at radical cystectomy, and downstaging were evaluated using sex-adjusted univariable and multivariable logistic regression modeling. We used interaction terms to account for age of menopause and smoking status. The association of sex with overall survival and cancer-specific survival was evaluated using Cox regression analyses.RESULTS:
A total of 1,031 patients were included in the analysis, 227 (22%) of whom were female. Female patients had a higher rate of extravesical disease extension (Pâ¯=â¯0.01). After the administration of NAC, ypT stage was equally distributed between sexes (Pâ¯=â¯0.39). On multivariable logistic regression analyses, there was no difference between the sexes or age of menopause with regards to ypT0N0 rates or downstaging (all P > 0.5). On Cox regression analyses, sex was associated with neither overall survival (hazard ratio 1.04, 95% confidence interval 0.75-1.45, Pâ¯=â¯0.81) nor cancer-specific survival (hazard ratio 1.06, 95% confidence interval 0.71-1.58, Pâ¯=â¯0.77).CONCLUSION:
Our study generates the hypothesis that NAC equalizes the preoperative disparity in pathologic stage between males and females suggesting a possible differential response between sexes. This might be the explanation underlying the comparable survival outcomes between sexes despite females presenting with more advanced tumor stage.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Bexiga Urinária
/
Quimioterapia Adjuvante
Tipo de estudo:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Urol Oncol
Ano de publicação:
2020
Tipo de documento:
Article