@article{bdd00d2f6dfa4c47af1afa49cb9cba3f,
title = "Impact of sex on response to neoadjuvant chemotherapy in patients with bladder cancer",
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.",
keywords = "Bladder cancer, Neoadjuvant chemotherapy, Response, Sex",
author = "David D'Andrea and Black, {Peter C.} and Homayoun Zargar and Kamran Zargar-Shoshtari and Sonja Zehetmayer and Fairey, {Adrian S.} and Mertens, {Laura S.} and Dinney, {Colin P.} and Mir, {Maria C.} and Krabbe, {Laura Maria} and Cookson, {Michael S.} and Jacobsen, {Niels Erik} and Montgomery, {Jeffrey S.} and Nikhil Vasdev and Yu, {Evan Y.} and Evanguelos Xylinas and Campain, {Nicholas J.} and Wassim Kassouf and Dall'Era, {Marc A.} and Seah, {Jo An} and Ercole, {Cesar E.} and Simon Horenblas and Sridhar, {Srikala S.} and McGrath, {John S.} and Jonathan Aning and Wright, {Jonathan L.} and Thorpe, {Andrew C.} and Morgan, {Todd M.} and Holzbeierlein, {Jeffrey M.} and Bivalacqua, {Trinity J.} and Scott North and Barocas, {Daniel A.} and Yair Lotan and Petros Grivas and Stephenson, {Andrew J.} and Shah, {Jay B.} and {van Rhijn}, {Bas W.} and Siamak Daneshmand and Spiess, {Philippe E.} and Shariat, {Shahrokh F.}",
note = "{\textcopyright} 2020 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/.",
year = "2020",
month = feb,
day = "11",
doi = "10.1016/j.urolonc.2020.01.010",
language = "English",
journal = "Urologic Oncology",
issn = "1078-1439",
publisher = "Elsevier",
}