The effect of gender on oncological outcomes in patients who have undergone radical cystectomy due to bladder cancer

Objective: The aim of this study was to evaluate the effect of gender on oncologic results in patients who have undergone radical cystectomy due to bladder cancer. Materials and methods: We retrospectively reviewed data from 460 patients who had radical cystectomy due to bladder cancer in our clinic. A total of 420 of the patients were men, and 40 patients were women. We evaluated the tumor type, tumor stage, tumor grade, lymph node involvement status, complications and survival rates of the females. These parameters were compared to male cystectomy data. Results: The median age of male and female patients was 60.59 +/- 8.966 and 63.2 +/- 7.816, respectively (p=0.076). In total, 79.4% of the males and 70.3% of females had transitional cell cancer (p=0.192). The detection frequencies for pT1, pT2, pT3 vs. pT4 stage tumors in males and females was 18%, 34.2%, 33.4% vs. 14% and 2.8%, 33.3%, 41.7%, 22.2%, respectively. The percentage of the lymph node involvement in female and male patients was 48.5% and 23.9% (p=0.02). The grade 3 tumor involvement in female and male patients was 80.6% and 72.7% (p=0.621). In females, the bladder-confined tumor percentage was 22.2% and males rate was 48.3% (p=0.04). In terms of overall complications, no significant differences were found between males and females. Disease-specific survival (DSS) was 115 +/- 42.2 months in males and 18 +/- 2.14 months in females. Three-year DSS was 61.4% in males and 15.3% in females (p=0.013). Median overall survival was 47 +/- 11.789 months in males and 18 +/- 1.581 months in females. Three-year overall survival was 53.2% for males and 11.4% for females. A significant difference was found between males and females (p=0.013). Conclusion: In this study, we found that females present worse disease specific and overall survival rates than males due to poor prognostic factors such as lymph node involvement and the higher prevalence of extravesical disease in female patients.