Characteristics of female non-muscle-invasive bladder cancer in Taiwan: association with upper tract urothelial carcinoma and end-stage renal disease.
OBJECTIVE
Urothelial carcinogenic mechanisms may differ between men and women. We investigated gender differences in the pathological characteristics and clinical outcomes of non-muscle-invasive bladder urothelial carcinoma (UC).


METHODS
We retrospectively reviewed a total of 413 consecutive patients, 285 men (69.0%) and 128 women (31.0%), with primary non-muscle-invasive bladder UC, treated with transurethral resection between January 1997 and July 2005. A single pathologist reviewed all pathology data. All statistical comparisons were two-sided.


RESULTS
Only a small proportion (2.3%) of female patients were current smokers compared with a larger proportion of males (48.1%). Female patients had more end-stage renal disease (ESRD) (20.3%) at diagnosis and/or previous or synchronous upper tract UC (34.4%) than males (5.6% and 14.7% for two disease conditions, respectively). There were no gender differences in pathological phenotypes such as tumor multiplicity, tumor grade, or stage. In a Cox proportional hazard model, female patients had more metachronous upper tract UC than males but had similar chances of recurrence and progression as males. Combining both genders, tumor multiplicity, stage, and continued smoking were independent prognostic factors predicting bladder recurrence.


CONCLUSIONS
There were no gender differences in clinicopathological characteristics such as tumor multiplicity, grade, stage, or risk of recurrence or progression. Smoking is not a major risk factor for women in Taiwan. Female patients with bladder cancer tended to have more upper tract UC and ESRD than males.
Chen
Chung-Hsin
CH
Department of Urology, National Taiwan University College of Medicine, Taipei, Taiwan.
Shun
Chia-Tung
CT
Huang
Kuo-How
KH
Huang
Chao-Yuan
CY
Yu
Hong-Jeng
HJ
Pu
Yeong-Shiau
YS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D007680:Kidney Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009378:Neoplasms, Multiple Primary / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013624:Taiwan; D014516:Ureteral Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000473:pathology