Gender-related Characteristics of Bladder Cancer Treatment

Summary

The most frequent cancer of the urinary tract is the bladder cancer (BC), in Italy its incidence reaches the 7% of all the new diagnosis of cancer, accounting for the fifth cause of death in the western countries, overall 140.000 new cases per year in Europe. In the year 2017, the Italian association for medical oncology (AIOM) recorded in our country about 21.700 new diagnosis of BC men and 5.300 in women. This data show not only a relevant gender disparity on the disease incidence (in 5th to 7th decade male incidence: 11-12% of all new diagnosis of cancer versus 1% in women) but also on the outcomes of treatment. Overall, the 30% of all the new diagnosis have a muscle-invasive (MIBC) onset, the female gender suffer a correlation with a more advanced disease at the time of first diagnosis. As a consequence, men have lower BC-related mortality when compared to women (p\<0,001). This discrepancy in the mortality rate has been investigated by many authors, resulting in the evidence that female gender suffers higher risks, especially during the first two-years after the radical cystectomy. A comprehensive explanation has not been formulated yet, but a multiplicity of cofactors, including variations in the hormone receptors and tumor biology as well as the different anatomy between male and female, have been identified as potentially relevant. Another important issue in the pre-operatory management of female patients with BC is the misleading interpretation of hematuria. It seems to directly correlate with the evidence that women suffer a more advanced stage at diagnosis, and this element has been withheld in the list of relevant risk factors for prognosis. Nevertheless, a thorough analysis of their effect will only be possible in the future, as well-designed prospective and randomized clinical trials are currently not available.

A part from the preoperatory disparity, it has also been described that men are more frequently candidates to an orthotopic urinary diversion, leading female patients to an irreversibly altered perception of personal integrity and body image, namely to a lower quality of life after radical cystectomy. The female anatomy has been considered as a limitation to continence recovery, resulting in preoperative counselling more frequently against in favor of ileal conduit or not-continent urinary diversions.

Conditions

• Bladder Cancer
• Radical Cystectomy
• Muscle-invasive Bladder Cancer

Sponsors & Collaborators

• marco Carini

  collaborator UNKNOWN

• Sergio Serni

  collaborator UNKNOWN

• Andrea Minervini

  collaborator UNKNOWN

• Pietro Spatafora

  collaborator UNKNOWN

• Giandomenico Roviello

  collaborator UNKNOWN

• Gabriella Nesi

  collaborator UNKNOWN

• Ilaria Camilla Galli

  collaborator UNKNOWN

• Calogero Saieva

  collaborator UNKNOWN

• Graziano Vignolini

  collaborator UNKNOWN

• Giovani Tasso

  collaborator UNKNOWN

• Simone Morselli

  collaborator UNKNOWN

• University of Florence

  lead OTHER

Eligibility

Min Age

18 Years

Max Age

99 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2020-09-01

Primary Completion

2021-04-30

Completion

2021-06-30

Countries

• Italy

Study Locations