Number Т. 9, № 3 (35) 2019

Female gender as a survival prognostic factor in patients with high-grade bladder cancer after surgical treatment

Yakovlev P.G.1, Klyushin D.A.2

Summary. Bladder cancer is a malignancy with prevalent in cadence amongmales. Nevertheless, females are considered the ones with more aggressive, more advanced at the diagnosis disease with worse survival rates than males. Aim. Тo determine the gender differences in incidence of high-grade bladder cancer, and survival depending on clinical stage of the cancer and method of surgical treatment. Materials and methods. Retrospective study of 364 patients with high-grade bladder cancer (males 305, females 59, ratio=5.2:1) surgically treated in 2004–2017 to reveal statistically significant correlation between gender and survival depending on clinical stage of the cancer (I, II, III, IV) and method of surgical treatment (transurethral resection, partial cystectomy, radical cystectomy). Results. We found that the higher the clinical stage of high-grade bladder cancer, the less is the incidence of cancer among females. There were no cases of advanced cancer not amenable to surgical treatment among females. Statistically significant difference was determined between survival curves of patients Stage IV in favor of female patients (р=0,035). In Stage I patients of both sexes and after transurethral resection there were no differences in survival (р=0,738). In Stages ІІ, ІІІ, and after partial or radical cystectomy the survival curves of females were higher than of males, but difference was not statistically significant (р=0,102). Expanding the pool of female patients might improve the accuracy of the statistical analysis. Conclusions. Incidence of and mortality from high grade bladder cancer is predominant among males, rises even higher in advanced stages of cancer. The outcomes of 5- and 10-year overall survival in females with high-grade disease are better in females. Statistically significant better survival was demonstrated in females with Stage IV high-grade bladder cancer. In other stages and after any surgical method of treatment the survival of females is better, but results were not statistically significant.
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