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GU Symposium 2021: Impact of Gender on Surgical Outcomes After Radical Cystectomy

By: Julia Fiederlein
Posted: Friday, February 12, 2021

Female patients with bladder cancer who underwent radical cystectomy seemed to experience slightly longer lengths of stay and less home discharge than their male counterparts, according to Srinath Kotamarti, MD, of Maimonides Medical Center, Brooklyn, New York, and colleagues. The results of this analysis, which were presented during the virtual edition of the 2021 Genitourinary (GU) Cancers Symposium (Abstract 402), revealed that the rates of major complications, reoperation, and mortality appeared to be similar among the sexes.

“Men have higher rates of bladder cancer and are more likely to undergo cystectomy than women, yet women seem to have worse oncologic outcomes. This is attributed to biologic factors including adverse histologic variants and social factors including delay in diagnosis,” the investigators remarked. “There is early evidence that women also have worse surgical outcomes.”

Using data from the American College of Surgeons National Surgical Quality Improvement Program database from 2012 through 2016, the investigators identified a total of 4,681 patients who underwent radical cystectomy. Of them, 18% were female.

Female gender seemed to be associated with longer operative time (350 vs. 336 minutes; P < .009), length of stay (8 vs. 7 days; P < .001), and lower rates of home discharge (79.9% vs. 87.0%; P < .0001), compared with males. Within 30 days of radical cystectomy, the rates of reoperation (female: 4.8%; male: 6.0%; P = .173), readmission (22.2% vs. 20.6%; P = .2904), and death (1.9% vs. 2.0%; P = .8467) did not seem to significantly differ between the sexes. Clavien-Dindo scores of 3 or higher (representing more severe complications) were reported in 16.6% of females and in 16.5% of males.

Disclosure: The study authors reported no conflicts of interest.



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