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    Impact of sex on response to neoadjuvant chemotherapy in patients with bladder cancer

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    URI
    https://rde.dspace-express.com/handle/11287/621352
    Author
    Campain, Nicholas J
    McGrath, John S
    Aning, Jonathan
    Date
    2020-07
    Journal
    Urologic Oncology
    Type
    Journal Article
    Publisher
    Elsevier Science
    DOI
    10.1016/j.urolonc.2020.01.010
    Rights
    Copyright © 2020 Elsevier Inc. All rights reserved.
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    Abstract
    Objective: To assess the effect of patient's sex on response to neoadjuvant chemotherapy (NAC) in patients with clinically nonmetastatic muscle-invasive bladder cancer (MIBC). Methods: Complete pathologic response, defined as ypT0N0 at radical cystectomy, and downstaging were evaluated using sex-adjusted univariable and multivariable logistic regression modeling. We used interaction terms to account for age of menopause and smoking status. The association of sex with overall survival and cancer-specific survival was evaluated using Cox regression analyses. Results: A total of 1,031 patients were included in the analysis, 227 (22%) of whom were female. Female patients had a higher rate of extravesical disease extension (P = 0.01). After the administration of NAC, ypT stage was equally distributed between sexes (P = 0.39). On multivariable logistic regression analyses, there was no difference between the sexes or age of menopause with regards to ypT0N0 rates or downstaging (all P > 0.5). On Cox regression analyses, sex was associated with neither overall survival (hazard ratio 1.04, 95% confidence interval 0.75-1.45, P = 0.81) nor cancer-specific survival (hazard ratio 1.06, 95% confidence interval 0.71-1.58, P = 0.77). Conclusion: Our study generates the hypothesis that NAC equalizes the preoperative disparity in pathologic stage between males and females suggesting a possible differential response between sexes. This might be the explanation underlying the comparable survival outcomes between sexes despite females presenting with more advanced tumor stage.
    Citation
    D'Andrea D et al. Impact of sex on response to neoadjuvant chemotherapy in patients with bladder cancer. Urol Oncol. 2020;38(7):639.e1-639.e9. doi:10.1016/j.urolonc.2020.01.010
    Publisher URL
    https://linkinghub.elsevier.com/retrieve/pii/S1078-1439(20)30011-9
    Collections
    • 2020 RD&E publications
    • HeSRU publications
    • Urology

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