膀胱癌诊断和治疗的性别差异。

IF 4.5 2区 医学 Q1 ONCOLOGY
Cancers Pub Date : 2024-12-07 DOI:10.3390/cancers16234100
Géraldine Pignot, Philippe Barthélémy, Delphine Borchiellini
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引用次数: 0

摘要

在不同类型的癌症中,患病率、肿瘤侵袭性、对治疗的反应和临床结果存在性别差异。本文的目的是总结膀胱癌诊断和治疗的性别差异,并试图提出改进的领域。尽管男性患膀胱肿瘤的风险更高,但女性在诊断时往往被诊断为更晚期,更有可能出现前期肌肉侵袭性疾病。非尿路上皮组织学亚型在女性中更为常见。关于非肌肉侵袭性膀胱癌(NMIBC),一些研究表明,由于免疫原性不同,女性在接受卡介苗治疗后疾病复发的风险更高。在局限性肌肉浸润性膀胱癌(MIBC)中,新辅助化疗和膀胱切除术不太可能在女性身上进行,并且很少提供性保留手术和新膀胱转移。最后,女性的预后似乎比男性差,这可能是由于宿主和肿瘤的性别相关的内在特征可能导致不同的治疗反应,特别是免疫治疗。女性也更有可能出现与全身治疗相关的严重不良事件,并且在随机研究中代表性不足,导致现实世界与试验之间存在差距。总之,迫切需要研究性别和性别的作用,以改善尿路上皮癌的管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Sex Disparities in Bladder Cancer Diagnosis and Treatment.

Gender differences in prevalence, tumor invasiveness, response to treatment, and clinical outcomes exist in different types of cancer. The aim of this article is to summarize the sex disparities in bladder cancer diagnosis and treatment and try to suggest areas for improvement. Although men are at a higher risk of developing bladder tumors, women tend to be diagnosed with more advanced stages at diagnosis and are more likely to present with upfront muscle-invasive disease. Non-urothelial histological subtypes are more frequently reported in women. Regarding non-muscle-invasive bladder cancer (NMIBC), several studies have shown that women have a higher risk of disease recurrence after treatment with Bacillus Calmette-Guerin, due to different immunogenicities. In localized muscle-invasive bladder cancer (MIBC), neoadjuvant chemotherapy and cystectomy are less likely to be performed on women and sexual-sparing procedures with neobladder diversion are rarely offered. Finally, women appear to have a poorer prognosis than men, potentially due to the sex-associated intrinsic features of hosts and tumors that may drive differential therapeutic responses, particularly to immune-based therapies. Women are also more likely to develop severe adverse events related to systemic therapies and are underrepresented in randomized studies, leading to a gap between the real world and trials. In conclusion, studies investigating the role of sex and gender are urgently needed to improve the management of urothelial carcinoma.

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来源期刊
Cancers
Cancers Medicine-Oncology
CiteScore
8.00
自引率
9.60%
发文量
5371
审稿时长
18.07 days
期刊介绍: Cancers (ISSN 2072-6694) is an international, peer-reviewed open access journal on oncology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.
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