title: The impact of female gender on bladder cancer-specific death risk after radical cystectomy: a meta-analysis of 27,912 patients.
abstract: OBJECTIVE
  To perform a first meta-analysis on the association between female gender and cancer-specific death risk after radical cystectomy.
  
  
  METHODS
  A comprehensive literature search of the MEDLINE and EMBASE databases was conducted for relevant studies published till November 11, 2014. The meta-analysis was performed by estimating the hazard ratios (HRs) and confidence intervals (CIs) through a random-effect approach.
  
  
  RESULTS
  A total of 17 studies were included in the meta-analysis with a total population of 27,912 patients. Female gender was associated with a worse survival outcome (pooled HR 1.20; 95 % CI 1.09-1.32) compared with male gender after radical cystectomy. Subgroup analysis found the correlation was significant in North American and European studies (HR 1.17, 95 % CI 1.02-1.32 and HR 1.34, 95 % CI 1.19-1.51, respectively) and studies from larger size of samples (HR 1.24, 95 % CI 1.11-1.38). We also found studies adjusted for the key elements (T stage, N stage and grade) obtained positive correlation (HR 1.21, 95 % CI 1.09-1.35).
  
  
  CONCLUSIONS
  Female demonstrated worse survival outcomes than male after radical cystectomy for bladder cancer. The adoption of more intense cares for female patients was suggested after radical cystectomy.
authors.affiliation: Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Shenghua
authors.initials: S
authors.lastname: Liu
authors.forename: Tian
authors.initials: T
authors.lastname: Yang
authors.forename: Rong
authors.initials: R
authors.lastname: Na
authors.forename: Mengbo
authors.initials: M
authors.lastname: Hu
authors.forename: Limin
authors.initials: L
authors.lastname: Zhang
authors.forename: You
authors.initials: Y
authors.lastname: Fu
authors.forename: Haowen
authors.initials: H
authors.lastname: Jiang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Ding
mesh_terms: D015653:Cystectomy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D018570:Risk Assessment; D017678:Sex Distribution; D012737:Sex Factors; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000601:surgery*