title: Does male sex influence the prognosis of patients with renal cancer?
abstract: BACKGROUND
  The aim of this study was to investigate the influence of sex on stage, grade, subtype, and prognosis of patients with renal cell carcinoma (RCC).
  
  
  METHODS
  This study included 1,810 patients treated by surgery for RCC at the University Hospitals of Hannover and Marburg between 1990 and 2005. The median follow-up was 54 months.
  
  
  RESULTS
  Of all the patients, 1,167 (64.5%) were men and 643 (35.5%) were women. Men were significantly younger (mean, 61.4 vs. 63.5 years; p < 0.001), and suffered more frequently from advanced tumor stages (45.2 vs. 37.6%; p = 0.002) and higher tumor grades (14.1 vs. 11.1%; p = 0.003). Kaplan Meier curves revealed a significant difference in cancer-specific survival between men and women (5-year survival 64.7 vs. 74.0%; p = 0.002). However, unlike tumor stage, grade, and N/M status, sex could not be retained as a significant independent prognostic marker in multivariate analysis.
  
  
  CONCLUSIONS
  RCC in men is characterized by higher tumor stages and more frequent metastasis at diagnosis along with inferior tumor-specific survival. However, as sex failed to qualify as an independent prognostic marker for cancer-specific survival, delayed diagnosis due to insufficient or neglected (routine) medical check-up and/or more aggressive tumor biology could be concurrently causative for the higher incidence of RCC in men.
authors.affiliation: Department of Urology, Hannover Medical School, Hannover, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Waalkes
authors.forename: Hendrik
authors.initials: H
authors.lastname: Rott
authors.forename: Thomas R W
authors.initials: TR
authors.lastname: Herrmann
authors.forename: Gerd
authors.initials: G
authors.lastname: Wegener
authors.forename: Mario W
authors.initials: MW
authors.lastname: Kramer
authors.forename: Axel S
authors.initials: AS
authors.lastname: Merseburger
authors.forename: Mark
authors.initials: M
authors.lastname: Schrader
authors.forename: Rainer
authors.initials: R
authors.lastname: Hofmann
authors.forename: Markus A
authors.initials: MA
authors.lastname: Kuczyk
authors.forename: Andres J
authors.initials: AJ
authors.lastname: Schrader
mesh_terms: D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000401:mortality*; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome