Impact of sex on response to neoadjuvant chemotherapy in patients with bladder cancer
| Autor: | Shahrokh F. Shariat, Marc A. Dall'Era, Yair Lotan, Niels Jacobsen, Homayoun Zargar, Scott North, Jonathan L. Wright, Evanguelos Xylinas, Jonathan Aning, Trinity J. Bivalacqua, Jo An Seah, Evan Y. Yu, Kamran Zargar-Shoshtari, Sonja Zehetmayer, Wassim Kassouf, John S. McGrath, Nicholas J. Campain, Andrew C. Thorpe, Maria Carmen Mir, Jeffrey S. Montgomery, Todd M. Morgan, Laura Maria Krabbe, Colin P.N. Dinney, Srikala S. Sridhar, Laura S. Mertens, Andrew J. Stephenson, Siamak Daneshmand, Philippe E. Spiess, Petros Grivas, Nikhil Vasdev, Peter C. Black, Daniel A. Barocas, Cesar E. Ercole, Jeffrey M. Holzbeierlein, David D'Andrea, Bas W.G. van Rhijn, Simon Horenblas, Michael S. Cookson, Jay B. Shah, Adrian Fairey |
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| Přispěvatelé: | Urology |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Oncology medicine.medical_specialty Urology medicine.medical_treatment 030232 urology & nephrology Logistic regression Cystectomy 03 medical and health sciences Sex Factors 0302 clinical medicine Internal medicine medicine Humans Stage (cooking) Aged Retrospective Studies Bladder cancer Proportional hazards model business.industry Hazard ratio Middle Aged medicine.disease Confidence interval Menopause Treatment Outcome Urinary Bladder Neoplasms Chemotherapy Adjuvant 030220 oncology & carcinogenesis Female business |
| Zdroj: | Urologic Oncology: Seminars and Original Investigations, 38(7), 639.e1-639.e9. Elsevier Inc. D'Andrea, D, Black, P C, Zargar, H, Zargar-Shoshtari, K, Zehetmayer, S, Fairey, A S, Mertens, L S, Dinney, C P, Mir, M C, Krabbe, L M, Cookson, M S, Jacobsen, N E, Montgomery, J S, Vasdev, N, Yu, E Y, Xylinas, E, Campain, N J, Kassouf, W, Dall'Era, M A, Seah, J A, Ercole, C E, Horenblas, S, Sridhar, S S, McGrath, J S, Aning, J, Wright, J L, Thorpe, A C, Morgan, T M, Holzbeierlein, J M, Bivalacqua, T J, North, S, Barocas, D A, Lotan, Y, Grivas, P, Stephenson, A J, Shah, J B, van Rhijn, B W, Daneshmand, S, Spiess, P E & Shariat, S F 2020, ' Impact of sex on response to neoadjuvant chemotherapy in patients with bladder cancer ', Urologic Oncology: Seminars and Original Investigations, vol. 38, no. 7, pp. 639.e1-639.e9 . https://doi.org/10.1016/j.urolonc.2020.01.010 |
| ISSN: | 1078-1439 |
| Popis: | 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 (P = 0.01). After the administration of NAC, ypT stage was equally distributed between sexes (P = 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, P = 0.81) nor cancer-specific survival (hazard ratio 1.06, 95% confidence interval 0.71–1.58, P = 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. |
| Databáze: | OpenAIRE |
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