Sex-related differences in oncological surgery and postoperative outcomes: comprehensive, nationwide study in France.

Autor:	Jochum F; Residual Tumour and Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France.; Department of Gynaecology, Strasbourg University Hospital, Strasbourg, France., Hamy AS; Residual Tumour and Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France.; Department of Medical Oncology, Institut Curie, Université Paris Cité, Paris, France., Gougis P; Residual Tumour and Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France., Dumas É; Residual Tumour and Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France., Grandal B; Residual Tumour and Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France.; Department of Breast and Gynaecological Surgery, Institut Curie, Paris, Université Paris Cité, Paris, France., Sauzey M; Residual Tumour and Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France.; Department of Breast and Gynaecological Surgery, Institut Curie, Paris, Université Paris Cité, Paris, France., Laas E; Department of Breast and Gynaecological Surgery, Institut Curie, Paris, Université Paris Cité, Paris, France., Feron JG; Department of Breast and Gynaecological Surgery, Institut Curie, Paris, Université Paris Cité, Paris, France., Fourchotte V; Department of Breast and Gynaecological Surgery, Institut Curie, Paris, Université Paris Cité, Paris, France., Gaillard T; Department of Breast and Gynaecological Surgery, Institut Curie, Paris, Université Paris Cité, Paris, France., Girard N; Department of Breast and Gynaecological Surgery, Institut Curie, Paris, Université Paris Cité, Paris, France., Pauly L; Department of Breast and Gynaecological Surgery, Institut Curie, Paris, Université Paris Cité, Paris, France., Gauroy E; Department of Breast and Gynaecological Surgery, Institut Curie, Paris, Université Paris Cité, Paris, France., Darrigues L; Department of Breast and Gynaecological Surgery, Institut Curie, Paris, Université Paris Cité, Paris, France., Hotton J; Department of Surgical Oncology, Institut Godinot, Reims, France., Lecointre L; Department of Gynaecology, Strasbourg University Hospital, Strasbourg, France., Reyal F; Residual Tumour and Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Paris, France.; Department of Breast and Gynaecological Surgery, Institut Curie, Paris, Université Paris Cité, Paris, France., Lecuru F; Department of Breast and Gynaecological Surgery, Institut Curie, Paris, Université Paris Cité, Paris, France., Akladios C; Department of Gynaecology, Strasbourg University Hospital, Strasbourg, France.
Jazyk:	angličtina
Zdroj:	The British journal of surgery [Br J Surg] 2024 Aug 02; Vol. 111 (8).
DOI:	10.1093/bjs/znae179
Abstrakt:	Background: The main objective of this study was to undertake an exhaustive investigation of sex-related differences in cancer surgery. Methods: This observational study used data from the French national health insurance system database covering 98.8% of the population. Patients diagnosed with non-sex-specific solid invasive cancers between January 2018 and December 2019 were included. The main outcomes were likelihood of undergoing cancer surgery, type of oncological surgery performed, and associated 30-, 60-, and 90-day postoperative reoperation and mortality rates, by sex. Results: For the 367 887 patients included, women were 44% more likely than men to undergo cancer surgery (OR 1.44, 95% c.i. 1.31 to 1.59; P < 0.001). However, the likelihood of surgery decreased with advancing age (OR 0.98, 0.98 to 0.98; P < 0.001), and with increasing number of co-morbid conditions (OR 0.95, 0.95 to 0.96; P < 0.001), especially in women. Men had higher 90-day reoperation (21.2 versus 18.8%; P < 0.001) and mortality (1.2 versus 0.9%; P < 0.001) rates than women, overall, and for most cancer types, with the exception of bladder cancer, for which the 90-day mortality rate was higher among women (1.8 versus 1.4%; P < 0.001). After adjustment for age, number of co-morbid conditions, and surgical procedure, 90-day mortality remained higher in men (OR 1.16, 1.07 to 1.26; P < 0.001), and men were 21% more likely than women to undergo reoperation within 90 days (OR 1.21, 1.18 to 1.23; P < 0.001). Conclusion: Women were much more likely than men to undergo cancer surgery than men, but the likelihood of surgery decreased with advancing age and with increasing number of co-morbid conditions, especially in women. These findings highlight a need for both increased awareness and strategies to ensure gender equality in access to oncological surgical treatment and improved outcomes. (© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.)
Databáze:	MEDLINE
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