#0405

Gender Differences in the Oncology Outcome of Upper Tract Urothelial Carcinoma (UTUC)

H. Li¹, H. Lee¹

¹Kaohsiung Medical University Chung-Ho Memorial Hospital, Urology department, Kaohsiung, Taiwan

Introduction:

Upper tract urothelial carcinoma (UTUC) is an aggressive malignancy with variable survival outcomes. This study aims to evaluate cancer-specific survival (CSS), disease-free survival (DFS), overall survival (OS), and bladder recurrence-free survival (BRFS) among UTUC patients, with a particular focus on gender differences and associated prognostic factors.

Material and methods:

A retrospective analysis was conducted on a cohort of 1,337 patients (male: 565, female: 772) diagnosed with UTUC. Survival outcomes, including CSS, DFS, OS, and BRFS, were analyzed using Kaplan-Meier survival curves, and differences between genders were assessed with the log-rank test. Cox proportional hazards regression models were used to identify independent prognostic factors. Baseline characteristics and clinical covariates, including age, comorbidities, ECOG performance status, tumor size, pathological stage, and treatment methods, were incorporated into multivariate models.

Results:

Kaplan-Meier survival analysis showed no statistically significant difference in CSS (p = 0.14), DFS (p = 0.19), or OS (p = 0.18) between male and female patients. However, BRFS was significantly better in females compared to males (p < 0.0001). In multivariate Cox regression analysis, female gender was associated with a reduced risk of bladder recurrence (HR = 0.55, 95% CI: 0.45–0.69, p < 0.001). Other significant predictors of survival outcomes included ECOG performance status, tumor stage, presence of lymphovascular invasion (LVI), surgical margin status, and preoperative hydronephrosis. Patients with high-grade tumors, multiple tumor locations, and advanced pathological stages demonstrated worse survival outcomes. Additionally, chemotherapy for UTUC was associated with poorer OS (HR = 1.64, p < 0.001) and CSS (HR = 3.70, p < 0.001), suggesting that these patients had more aggressive disease.