AUA: Women with Non-Muscle Invasive Bladder SCC Have Worse Disease-Free Survival
(ChemotherapyAdvisor) – Women who have clinically localized squamous cell carcinoma (SCC) of the bladder appear to have worse disease-specific survival than men, with the difference most prominent in those with non-muscle invasive cancer, according to a May 22 presentation at the American Urological Association Annual Meeting in Atlanta, GA.
Although prior studies have noted a worse disease-specific survival in women than in men with urothelial carcinoma of the bladder, SCC is a distinct disease that has not been as thoroughly studied. Using the Surveillance Epidemiology and End Results (SEER) national cancer registry, the investigators compared disease-specific survival among men and women with SCC, including the effect of tumor stage and treatment type.
They identified 2,523 cases of SCC, 1,248 in women and 1,275 in men. Women were significantly older than men at diagnosis, a mean age of 72.8 years vs. 71.0 years (P<0.001). Adjusting for demographic and tumor characteristics, women had a 20% increased risk of mortality vs. men (HR 1.2; P=0.002); a similar difference was observed when the analysis was restricted to those who received cystectomy (HR 1.2).
However, no survival difference was found between men and women with positive lymph nodes or distant metastases (HR 1.1; P=0.345). When stratified by tumor stage, among those with non-muscle invasive disease (Ta, Tis, and T1), women were at 2.3-fold higher risk of death (P=0.002). The investigators noted that women with muscle invasive disease (T2) and disease extending outside the serosa of the bladder (T3 and T4) tended to have a higher risk of mortality; however, this difference was not significant: HR 1.1; P=0.373 and HR 1.1; P=0.310, respectively.
“Taken together, these differences in disease-specific survival between men and women with localized SCC of the bladder suggest that the nature of the tumor, delivery of therapy, or response to therapy differs by gender,” they noted.