The impact of female gender on bladder cancer-specific death risk after radical cystectomy: a meta-analysis of 27,912 patients

Objective To perform a first meta-analysis on the association between female gender and cancer-specific death risk after radical cystectomy. Materials and methods A comprehensive literature search of the MEDLINE and EMBASE databases was conducted for relevant studies published till November 11, 2014. The meta-analysis was performed by estimating the hazard ratios (HRs) and confidence intervals (CIs) through a random-effect approach. Results A total of 17 studies were included in the meta-analysis with a total population of 27,912 patients. Female gender was associated with a worse survival outcome (pooled HR 1.20; 95 % CI 1.09–1.32) compared with male gender after radical cystectomy. Subgroup analysis found the correlation was significant in North American and European studies (HR 1.17, 95 % CI 1.02–1.32 and HR 1.34, 95 % CI 1.19–1.51, respectively) and studies from larger size of samples (HR 1.24, 95 % CI 1.11–1.38). We also found studies adjusted for the key elements (T stage, N stage and grade) obtained positive correlation (HR 1.21, 95 % CI 1.09–1.35). Conclusions Female demonstrated worse survival outcomes than male after radical cystectomy for bladder cancer. The adoption of more intense cares for female patients was suggested after radical cystectomy.