Gender differences in clinicopathological features and survival in surgically treated patients with renal cell carcinoma: An analysis of the multicenter CORONA database

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. FigenshauKerry Madison, Manuel Sánchez-Chapado, Maria del Carmen Santiago Martin, Luigi Salzano, Giuseppe Lotrecchiano, Steven Joniau, Raphaela Waidelich, Christian Stief, Sabine Brookman-May

Research output: Contribution to journalArticle

Abstract

Purpose: To investigate gender differences in clinicopathological features and to analyze the prognostic impact of gender in renal cell carcinoma (RCC) patients undergoing surgery. Methods: A 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). Results: A 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. Conclusions: This 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.

Original languageEnglish
Pages (from-to)1073-1080
Number of pages8
JournalWorld Journal of Urology
Volume31
Issue number5
DOIs
Publication statusPublished - Oct 2013

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Keywords

  • Age groups
  • Gender
  • Histological subtypes
  • Nephrectomy
  • Prognosis
  • Renal cell carcinoma

ASJC Scopus subject areas

  • Urology

Cite this

May, M., Aziz, A., Zigeuner, R., Chromecki, T., Cindolo, L., Schips, L., De Cobelli, O., Rocco, B., De Nunzio, C., Tubaro, A., Coman, I., Truss, M., Dalpiaz, O., Hoschke, B., Gilfrich, C., Feciche, B., Stoltze, A., Fenske, F., Fritsche, H. M., ... Brookman-May, S. (2013). Gender differences in clinicopathological features and survival in surgically treated patients with renal cell carcinoma: An analysis of the multicenter CORONA database. World Journal of Urology, 31(5), 1073-1080. https://doi.org/10.1007/s00345-013-1071-x