Higher Progression Risk in Women With Advanced Urothelial Carcinoma

Women with advanced urothelial carcinoma have a significantly greater risk of progression after chemotherapy than men with the disease, a recent study showed.

Lucrezia Becattini, of the University of Florence in Italy, and colleagues conducted the study and published its results in Medicina.

“The incidence of urothelial cancer in males is higher than in females; however, females have a higher risk of recurrence and progression,” the authors wrote. “The aim of our study was to report the effect of gender on the oncological outcome in advanced urothelial cancer.”

The retrospective study included 74 patients who underwent primary surgical treatment for urothelial carcinoma and had stage 4 disease when they underwent chemotherapy. Most patients (76%) were male. The researchers evaluated the patients’ response to therapy, the toxicity of the treatment, as well as patients’ tumor presentation, first- and second-line treatment response, progression-free survival (PFS), and overall survival (OS).

Men had a higher PFS rate than women after first-line chemotherapy (P=.051) and second-line chemotherapy (P=.018). Men also had a significantly lower risk of progression (hazard ratio [HR], 0.29; 95% CI, 0.10-0.86; P=.026) than women. However, the OS rate was significantly higher in women (27.5%) than in men (17.4%; P=.047), and men had a higher risk of death “with borderline statistical significance” (HR, 2.28; P=.053).

The researchers found the only significant difference in the distribution of individual characteristics by gender was in smoking prevalence, with a significantly higher prevalence of smokers in the group of female patients (P=.029). However, smoking did not have a significant impact on OS (P=.055).

“In our series, PFS rates following first- and second-line therapies for advanced urothelial carcinoma confirmed that females have a greater risk of progression than males,” the authors concluded.

Becattini L, Saieva C, Doni L, et al. Gender and advanced urothelial cancer: outcome, efficacy and toxicity following chemotherapy. Medicina (Kaunas). 2022;58(7):886. doi:10.3390/medicina58070886