title: Gender differences in clinicopathological features and survival in surgically treated patients with renal cell carcinoma: an analysis of the multicenter CORONA database.
abstract: OBJECTIVE
  To investigate gender differences in clinicopathological features and to analyze the prognostic impact of gender in renal cell carcinoma (RCC) patients undergoing surgery.
  
  
  METHODS
  A total of 6,234 patients (eleven centers; Europe and USA) treated by radical or partial nephrectomy were included in this retrospective study (median follow-up 59 months; IQR 30-106). Gender differences in clinicopathological parameters were assessed. Multivariable Cox regression models were applied to determine the influence of parameters on disease-specific survival (DSS) and overall survival (OS).
  
  
  RESULTS
  A total of 3,751 patients of the study group were male patients (60.2 %), who were significantly younger at diagnosis and received more frequently NSS than women. Significantly, more often high-grade tumors and simultaneous metastasis were present in men. Whereas tumor size and pTN stages did not differ between genders, clear-cell and chromophobe RCC was diagnosed less frequently, but papillary RCC more often in men. Gender also independently influenced DSS (HR 0.75, p < 0.001) and OS (HR 0.80, p < 0.001) with a benefit for women. However, inclusion of gender in multivariable models did not significantly gain predictive accuracies (PA) for DSS (0.868-0.870, p = 0.628) and OS (0.775-0.777, p = 0.522). Furthermore, no significantly different DSS and OS rates were found in patients undergoing NSS.
  
  
  CONCLUSIONS
  This study demonstrates important gender differences in clinicopathological features and outcome of RCC patients with improved DSS and OS for women compared to men, even if solely patients with clear-cell RCC or M0-stage are taken into evaluation. However, inclusion of gender in multivariable models does not significantly gain PA of multivariable models.
authors.affiliation: Department of Urology, St. Elisabeth Hospital Straubing, Straubing, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: May
authors.forename: Atiqullah
authors.initials: A
authors.lastname: Aziz
authors.forename: Richard
authors.initials: R
authors.lastname: Zigeuner
authors.forename: Thomas
authors.initials: T
authors.lastname: Chromecki
authors.forename: Luca
authors.initials: L
authors.lastname: Cindolo
authors.forename: Luigi
authors.initials: L
authors.lastname: Schips
authors.forename: Ottavio
authors.initials: O
authors.lastname: De Cobelli
authors.forename: Bernardo
authors.initials: B
authors.lastname: Rocco
authors.forename: Cosimo
authors.initials: C
authors.lastname: De Nunzio
authors.forename: Andrea
authors.initials: A
authors.lastname: Tubaro
authors.forename: Ioman
authors.initials: I
authors.lastname: Coman
authors.forename: Michael
authors.initials: M
authors.lastname: Truss
authors.forename: Orietta
authors.initials: O
authors.lastname: Dalpiaz
authors.forename: Bernd
authors.initials: B
authors.lastname: Hoschke
authors.forename: Christian
authors.initials: C
authors.lastname: Gilfrich
authors.forename: Bogdan
authors.initials: B
authors.lastname: Feciche
authors.forename: Anette
authors.initials: A
authors.lastname: Stoltze
authors.forename: Fabian
authors.initials: F
authors.lastname: Fenske
authors.forename: Hans-Martin
authors.initials: HM
authors.lastname: Fritsche
authors.forename: Robert S
authors.initials: RS
authors.lastname: Figenshau
authors.forename: Kerry
authors.initials: K
authors.lastname: Madison
authors.forename: Manuel
authors.initials: M
authors.lastname: Sánchez-Chapado
authors.forename: Maria Del Carmen Santiago
authors.initials: Mdel C
authors.lastname: Martin
authors.forename: Luigi
authors.initials: L
authors.lastname: Salzano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lotrecchiano
authors.forename: Steven
authors.initials: S
authors.lastname: Joniau
authors.forename: Raphaela
authors.initials: R
authors.lastname: Waidelich
authors.forename: Christian
authors.initials: C
authors.lastname: Stief
authors.forename: Sabine
authors.initials: S
authors.lastname: Brookman-May
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome