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Gender differences in clinicopathological features and survival in surgically treated patients with renal cell carcinoma: an analysis of the multicenter CORONA database |
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| Authors: | Matthias May Atiqullah Aziz Richard Zigeuner Thomas Chromecki Luca Cindolo Luigi Schips Ottavio De Cobelli Bernardo Rocco Cosimo De Nunzio Andrea Tubaro Ioman Coman Michael Truss Orietta Dalpiaz Bernd Hoschke Christian Gilfrich Bogdan Feciche Anette Stoltze Fabian Fenske Hans-Martin Fritsche Robert S. Figenshau Kerry Madison Manuel Sánchez-Chapado Maria del Carmen Santiago Martin Luigi Salzano Giuseppe Lotrecchiano Steven Joniau Raphaela Waidelich Christian Stief Sabine Brookman-May |
| Affiliation: | 1. Department of Urology, St. Elisabeth Hospital Straubing, Straubing, Germany 2. Department of Urology, Caritas St. Josef Medical School, University of Regensburg, Regensburg, Germany 3. Department of Urology, Medical University of Graz, Graz, Austria 4. Department of Urology, Pio Da Pietrelcina Hospital, Vasto, Italy 5. Division of Urology, European Institute of Oncology, Milan, Italy 6. Department of Urology, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy 7. Department of Urology, Faculty of Health Sciences, University “La Sapienza”, Ospedale Sant’Andrea, Rome, Italy 8. Department of Urology, Clinical Municipal Hospital, Cluj-Napoca, Romania 9. Department of Urology, Klinikum Dortmund, Dortmund, Germany 10. Department of Urology, Carl-Thiem-Klinikum Cottbus, Cottbus, Germany 11. Department of Urology, Emergency Hospital Satu Mare, Satu Mare, Romania 12. Department of Surgery, Division of Urologic Surgery, Washington University School of Medicine, St. Louis, WA, USA 13. Department of Urology, Alcala de Henares, Hospital Universitario Principe de Asturias, Madrid, Spain 14. Department of Urology, G. Rummo Hospital, Benevento, Italy 15. Department of Urology, University Hospitals Leuven, Leuven, Belgium 16. Department of Development and Regeneration, KU Leuven, Leuven, Belgium 17. Department of Urology, Klinikum Grosshadern, Ludwig-Maximilians-University Munich, Munich, Germany |
| Abstract: | PurposeTo investigate gender differences in clinicopathological features and to analyze the prognostic impact of gender in renal cell carcinoma (RCC) patients undergoing surgery.MethodsA 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).ResultsA 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.ConclusionsThis 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. |
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