title: Female Gender Is an Age-dependent Negative Prognostic Factor for Patients with Upper Tract Urothelial Carcinoma.
abstract: OBJECTIVE
  To analyze female gender as a possible age-dependent prognostic factor for overall (OS) and cancer-specific survival (CSS) in patients with upper urinary tract urothelial carcinoma (UUTUC) after radical nephroureterectomy (RNU).
  
  
  METHODS
  A total of 167 men and 101 women with UUTUC treated with RNU with bladder cuff resection at our clinic were retrospectively analyzed. Female patients were divided into pre- and post-menopausal groups and compared against male patients of the same age. We used a cut-off age of 59 years or more as a surrogate for the post-menopausal hormonal status of women. Kaplan-Meier analyses and multivariate Cox proportional hazards regression analyses were performed to analyze gender as a possible prognostic factor of OS and CSS.
  
  
  RESULTS
  Women aged 59 years or more had a significantly worse CSS with an average of 231 months after RNU compared to 303 months for their male counterparts (p=0.011). Univariate Cox regression analysis showed a 2.44-fold higher risk of death (p=0.013), while multivariate analyses, adjusted for tumor stage and tumor grade, showed a 2.92-fold higher risk (p=0.011) of cancer-specific death for women aged 59 years or more.
  
  
  CONCLUSIONS
  Female gender is an age-dependent prognostic factor for CSS for patients with UUTUC treated with RNU.
authors.affiliation: Department of Urology, University Hospital Erlangen, Erlangen, Germany danijel.sikic@uk-erlangen.de.
authors.forename: Danijel
authors.initials: D
authors.lastname: Sikic
authors.affiliation: Department of Urology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Wach
authors.affiliation: Department of Urology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Helge
authors.initials: H
authors.lastname: Taubert
authors.affiliation: Department of Urology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Mario
authors.initials: M
authors.lastname: Richterstetter
authors.affiliation: Department of Urology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Kunath
authors.affiliation: Department of Urology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Goebell
authors.affiliation: Tumour Centre at the Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schick
authors.affiliation: Department of Urology and Pediatric Urology, Philipps University of Marburg, Marburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Olbert
authors.affiliation: Department of Urology, Carl Gustav Carus University Hospital, Dresden, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Huber
authors.affiliation: Department of Urology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Wullich
authors.affiliation: Department of Urology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: Bastian
authors.initials: B
authors.lastname: Keck
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009392:Nephrectomy / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D014551:Urinary Tract / Q000473:pathology*; D014571:Urologic Neoplasms / Q000473:pathology*; D019459:Urothelium / Q000473:pathology*
keywords: Urothelial carcinoma; age at diagnosis; cancer-specific survival; gender; upper urinary tract