Rates of Systemic Therapy for Metastatic Bladder Cancer Are Lower in Unmarried Males and Females

IF 2.3 3区 医学 Q3 ONCOLOGY
Kira Vitucci , Carolin Siech , Andrea Baudo , Letizia M.I Jannello , Mario de Angelis , Francesco Di Bello , Jordan A. Goyal , Zhe Tian , Fred Saad , Shahrokh F. Shariat , Nicola Longo , Luca Carmignani , Ottavio de Cobelli , Alberto Briganti , Luis A. Kluth , Felix K.H. Chun , Pierre I. Karakiewicz
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Abstract

Objective

Systemic therapy is guideline-recommended for metastatic urothelial carcinoma of the urinary bladder (UCUB). Unmarried status represents an important barrier to treatment access in many primaries. The importance of married status is unknown in the context of systemic therapy in metastatic UCUB and was addressed in the current study.

Methods

We relied on the Surveillance, Epidemiology, and End Results database (2004-2020) to identify patients with metastatic UCUB. Univariable and multivariable logistic regression models were fitted to address systemic therapy rates. Additionally, temporal trends were plotted.

Results

Overall, 6873 patients with stage IV UCUB were identified. Of those, 4853 (71%) were male. Of males, 2993 (62%) were married vs. 797 (39%) of females. The rates of systemic therapy were 55% in both married males and married females. Married males and females differed from their unmarried counterparts regarding age and race/ethnicity. In males, prior to any adjustment, married status was associated with an odds ratio of 1.46 (P < .001). After adjustment for age and race/ethnicity, the odds ratio increased to 1.73 (P < .001). In females, prior to any adjustment, married status was associated with an odds ratio of 1.94 (P < .001). After adjustment for age and race/ethnicity, the odds ratio decreased to 1.57 (P < .001).

Conclusion

Unmarried males and unmarried females are significantly exposed to lower access to systemic therapy compared to their married counterparts. In consequence, both unmarried men and unmarried women should be given very careful consideration when use of systemic therapy in metastatic UCUB is contemplated.

未婚男性和女性接受转移性膀胱癌系统治疗的比例较低
目标系统疗法是指南推荐的转移性膀胱尿路上皮癌(UCUB)治疗方法。未婚是许多初诊患者接受治疗的重要障碍。已婚状态在转移性 UCUB 系统性治疗中的重要性尚不清楚,本研究对此进行了探讨。采用单变量和多变量逻辑回归模型来分析系统治疗率。此外,还绘制了时间趋势图。结果共识别出 6873 名 IV 期 UCUB 患者。其中 4853 例(71%)为男性。男性中有 2993 人(62%)已婚,女性中有 797 人(39%)已婚。已婚男性和已婚女性接受系统治疗的比例均为 55%。在年龄和种族/民族方面,已婚男性和女性与未婚男性和女性有所不同。就男性而言,在进行任何调整之前,已婚状态与 1.46 的几率比(P <.001)相关。对年龄和种族/族裔进行调整后,几率比上升到 1.73(P < .001)。就女性而言,在进行任何调整之前,已婚状态与 1.94(P <.001)的几率比相关。结论 与已婚男性和女性相比,未婚男性和女性接受系统治疗的机会明显较少。因此,在考虑对转移性 UCUB 使用全身治疗时,未婚男性和未婚女性都应慎重考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical genitourinary cancer
Clinical genitourinary cancer 医学-泌尿学与肾脏学
CiteScore
5.20
自引率
6.20%
发文量
201
审稿时长
54 days
期刊介绍: Clinical Genitourinary Cancer is a peer-reviewed journal that publishes original articles describing various aspects of clinical and translational research in genitourinary cancers. Clinical Genitourinary Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of genitourinary cancers. The main emphasis is on recent scientific developments in all areas related to genitourinary malignancies. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.
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