Does male sex influence the prognosis of patients with renal cancer?

Onkologie. 2011;34(1-2):24-8. doi: 10.1159/000323379. Epub 2011 Jan 24.

Abstract

Background: The aim of this study was to investigate the influence of sex on stage, grade, subtype, and prognosis of patients with renal cell carcinoma (RCC).

Patients and methods: This study included 1,810 patients treated by surgery for RCC at the University Hospitals of Hannover and Marburg between 1990 and 2005. The median follow-up was 54 months.

Results: Of all the patients, 1,167 (64.5%) were men and 643 (35.5%) were women. Men were significantly younger (mean, 61.4 vs. 63.5 years; p < 0.001), and suffered more frequently from advanced tumor stages (45.2 vs. 37.6%; p = 0.002) and higher tumor grades (14.1 vs. 11.1%; p = 0.003). Kaplan Meier curves revealed a significant difference in cancer-specific survival between men and women (5-year survival 64.7 vs. 74.0%; p = 0.002). However, unlike tumor stage, grade, and N/M status, sex could not be retained as a significant independent prognostic marker in multivariate analysis.

Conclusions: RCC in men is characterized by higher tumor stages and more frequent metastasis at diagnosis along with inferior tumor-specific survival. However, as sex failed to qualify as an independent prognostic marker for cancer-specific survival, delayed diagnosis due to insufficient or neglected (routine) medical check-up and/or more aggressive tumor biology could be concurrently causative for the higher incidence of RCC in men.

MeSH terms

  • Carcinoma, Renal Cell / mortality*
  • Carcinoma, Renal Cell / surgery*
  • Female
  • Germany / epidemiology
  • Humans
  • Kidney Neoplasms / mortality*
  • Kidney Neoplasms / surgery*
  • Male
  • Middle Aged
  • Nephrectomy / mortality*
  • Prevalence
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Sex Distribution
  • Survival Analysis
  • Survival Rate
  • Treatment Outcome