Sex-related differences in clinicopathological features and survival of patients with primary urethral carcinoma: a population-based study

Figures & data

Table 1 Characteristics of patients

	Women (%), n=166	Men (%), n=287	Total (%), n=453
Median survival, months (IQR)	20 (9–44.8)	21 (8–43)	20 (9–44)
Year of diagnosis
2004–2008	87 (52.4)	150 (52.3)	237 (52.3)
2009–2013	79 (47.6)	137 (47.7)	216 (47.7)
Age at diagnosis, years
0–54	30 (18.1)	61 (21.3)	91 (20.1)
55–64	43 (25.9)	59 (20.6)	102 (22.5)
65–74	42 (25.3)	65 (22.6)	107 (23.6)
75–84	31 (18.7)	70 (24.4)	101 (22.3)
85+	20 (12)	32 (11.1)	52 (11.5)
Race
White	102 (61.4)	236 (82.2)	338 (74.6)
Black	50 (30.1)	35 (12.2)	85 (18.8)
Others	14 (8.4)	16 (5.6)	30 (6.6)
Marital status
Not married	99 (59.6)	88 (30.7)	187 (41.3)
Married (including common law)	58 (34.9)	184 (64.1)	242 (53.4)
Unknown	9 (5.4)	15 (5.2)	24 (5.3)
Grade
Grade I and grade II	58 (34.9)	73 (25.4)	131 (28.9)
Grade III	63 (38)	96 (33.4)	159 (35.1)
Grade IV	22 (13.3)	67 (23.3)	89 (19.6)
Unknown	23 (13.9)	51 (17.8)	74 (16.3)
Tumor size, cm
≤2	23 (13.9)	26 (9.1)	49 (10.8)
>2 and ≤5	40 (24.1)	65 (22.6)	105 (23.2)
>5	14 (8.4)	34 (11.8)	48 (10.6)
Unknown	89 (53.6)	162 (56.4)	251 (55.4)
Positive-node status
0	30 (18.1)	25 (8.7)	55 (12.1)
1–3	22 (13.3)	28 (9.8)	50 (11)
>3	0	7 (2.4)	7 (1.5)
Unknown	114 (68.7)	227 (79.1)	341 (75.3)
AJCC stage
I	38 (22.9)	73 (25.4)	111 (24.5)
II	23 (13.9)	56 (19.5)	79 (17.4)
III and IV	94 (56.6)	119 (41.5)	213 (47)
Unknown	11 (6.6)	39 (13.6)	50 (11)
pT stage
T0 and T1	43 (25.9)	91 (31.7)	134 (29.6)
T2	31 (18.7)	85 (29.6)	116 (25.6)
T3	57 (34.3)	44 (15.3)	101 (22.3)
T4 and TX	35 (21.1)	67 (23.3)	102 (22.5)
pN stage
N0	118 (71.1)	195 (67.9)	313 (69.1)
N1	21 (12.7)	36 (12.5)	57 (12.6)
N2	16 (9.6)	26 (9.1)	42 (9.3)
NX	11 (6.6)	30 (10.5)	41 (9.1)
pM stage
M0	143 (86.1)	234 (81.5)	377 (83.2)
M1	17 (10.2)	34 (11.8)	51 (11.3)
MX	6 (3.6)	19 (6.6)	25 (5.5)
Surgery
No	60 (36.1)	77 (26.8)	137 (30.2)
Yes	106 (63.9)	210 (73.2)	316 (69.8)
Radiation
Yes	69 (41.6)	67 (23.3)	136 (30)
No	97 (58.4)	220 (76.7)	317 (70)
Histological type
SCC, NOS	52 (31.3)	113 (39.4)	165 (36.4)
TCC, NOS	54 (32.5)	148 (51.6)	202 (44.6)
Ac, NOS	60 (36.1)	26 (9.1)	86 (19)

Abbreviations: AJCC, American Joint Committee on Cancer; SCC, squamous cell carcinoma; TCC, transitional cell carcinoma; Ac, adenocarcinoma; NOS, not otherwise specified.

Figure 1 Kaplan–Meier plots of cancer-specific survival (A) and overall survival (B) of women and men.

Figure 2 Kaplan–Meier plots of cancer-specific survival of adenocarcinoma stratified by sex.

Figure 3 Kaplan–Meier plots of cancer-specific survival in men patients stratified by transitional cell carcinoma (TCC) and adenocarcinoma (Ac).

Figure 4 Kaplan–Meier plots of cancer-specific survival in men patients stratified by transitional cell carcinoma (TCC) and squamous cell carcinoma (SCC).

Table 2 Univariate and multivariate analysis of overall survival in women

	Univariate analysis		Multivariate analysis
	HR (95% CI)	P-value	HR (95% CI)	P-value
Year of diagnosis
2004–2008	Reference
2009–2013	0.7 (0.43–1.13)	0.14
Age at diagnosis, years
0–54	Reference
55–64	0.71 (0.34–1.45)	0.35
65–74	1.1 (0.55–2.18)	0.79
75–84	1.45 (0.74–2.84)	0.28
85+	1.76 (0.84–3.68)	0.14
Race
White	Reference		Reference
Black	1.68 (1.07–2.62)	0.02*	1.73 (1.01–2.96)	0.04*
Other	1 (0.43–2.35)	1	0.83 (0.33–2.1)	0.69
Marital status
Not married	Reference		Reference
Married	0.62 (0.38–1)	0.049*	0.72 (0.43–1.22)	0.22
Unknown	1.77 (0.8–3.91)	0.16	1.05 (0.39–2.77)	0.93
Grade
I and II	Reference		Reference
III	1.86 (1.11–3.11)	0.02*	1.59 (0.9–2.83)	0.11
IV	0.94 (0.4–2.2)	0.89	1.02 (0.41–2.54)	0.97
Unknown	2.11 (1.13–3.96)	0.02*	1.7 (0.81–3.58)	0.16
Tumor size, cm
≤2	Reference
>2 and ≤5	1.21 (0.57–2.56)	0.62
>5	0.92 (0.34–2.55)	0.88
Unknown	1.15 (0.58–2.27)	0.7
Positive-node status
0	Reference
1–3	1.29 (0.61–2.7)	0.51
>3	–	–
Unknown	1.26 (0.72–2.23)	0.42
AJCC stage
I	Reference		Reference
II	0.44 (0.25–0.77)	<0.001*	0.77 (0.1–5.89)	0.8
III and IV	0.61 (0.35–1.05)	0.08	1.06 (0.18–6.27)	0.94
Unknown	1.2 (0.75–1.92)	0.44	0.6 (0.08–4.32)	0.62
pT stage
T0 and T1	Reference		Reference
T2	1 (0.5–2.04)	0.99	1.43 (0.22–9.1)	0.71
T3	2.09 (1.17–3.71)	0.01*	1.35 (0.26–7.08)	0.73
T4 and TX	2.04 (1.09–3.81)	0.03*	1.35 (0.25–7.23)	0.73
pN stage
N0	Reference		Reference
N1	1.07 (0.56–2.04)	0.83	0.78 (0.32–1.93)	0.6
N2	2.24 (1.13–4.43)	0.02*	1.33 (0.61–2.91)	0.48
NX	1.31 (0.6–2.87)	0.5	0.89 (0.21–3.83)	0.88
pM stage
M0	Reference		Reference
M1	4.2 (2.4–7.37)	<0.001*	2.3 (1.07–4.93)	0.03*
MX	1.31 (0.48–3.6)	0.6	1.97 (0.36–10.9)	0.44
Surgery
No	Reference		Reference
Yes	0.49 (0.32–0.75)	0.001*	0.56 (0.33–0.93)	0.03*
Radiation
Yes	Reference
No	1.17 (0.76–1.81)	0.47
Histological type
SCC, NOS	Reference
TCC, NOS	1.05 (0.61–1.83)	0.85
Ac, NOS	1.34 (0.8–2.27)	0.27

Note:

* P<0.05.

Abbreviations: AJCC, American Joint Committee on Cancer; SCC, squamous cell carcinoma; TCC, transitional cell carcinoma; Ac, adenocarcinoma; NOS, not otherwise specified.

Table 3 Univariate and multivariate analysis of cancer-specific survival in women

	Univariate analysis		Multivariate analysis
	HR (95% CI)	P-value	HR (95% CI)	P-value
Year of diagnosis
2004–2008	Reference
2009–2013	0.9 (0.53–1.51)	0.68
Age at diagnosis, years
0–54	Reference
55–64	0.74 (0.35–1.55)	0.42
65–74	0.72 (0.33–1.59)	0.42
75–84	1.28 (0.62–2.63)	0.51
85+	1.08 (0.45–2.62)	0.86
Race
White	Reference		Reference
Black	1.94 (1.16–3.22)	0.01*	1.85 (1.01–3.39)	0.048*
Other	1.23 (0.48–3.15)	0.67	0.95 (0.33–2.71)	0.92
Marital status
Not married	Reference		Reference
Married	0.48 (0.27–0.86)	0.01*	0.56 (0.3–1.06)	0.07
Unknown	1.49 (0.59–3.78)	0.4	0.84 (0.27–2.61)	0.77
Grade
I and II	Reference		Reference
III	1.97 (1.07–3.63)	0.03*	1.64 (0.83–3.22)	0.15
IV	1.33 (0.55–3.23)	0.53	1.55 (0.59–4.05)	0.37
Unknown	2.23 (1.07–4.65)	0.03*	1.61 (0.67–3.88)	0.28
Tumor size, cm
≤2	Reference
>2 and ≤5	1.21 (0.49–2.97)	0.68
>5	0.7 (0.18–2.69)	0.6
Unknown	1.41 (0.63–3.14)	0.41
Positive-node status
0	Reference
1–3	1.64 (0.72–3.73)	0.23
.3	–	–
Unknown	1.26 (0.65–2.46)	0.49
AJCC stage
I	Reference		Reference
II	1.5 (0.5–4.47)	0.47	1.51 (0.17–13.58)	0.71
III and IV	3.06 (1.29–7.27)	0.01*	2.6 (0.38–17.55)	0.33
Unknown	2.42 (0.77–7.64)	0.13	1.58 (0.17–15.11)	0.69
pT stage
T0 and T1	Reference		Reference
T2	1.6 (0.65–3.94)	0.31	1.2 (0.18–7.85)	0.85
T3	3.56 (1.67–7.59)	<0.001*	1.14 (0.21–6.28)	0.88
T4 and TX	3.56 (1.59–7.96)	<0.001*	1.09 (0.19–6.2)	0.92
pN stage
N0	Reference		Reference
N1	1.56 (0.8–3.04)	0.19	0.91 (0.35–2.32)	0.84
N2	2.79 (1.34–5.82)	0.01*	1.49 (0.64–3.46)	0.35
NX	1.33 (0.52–3.37)	0.55	0.32 (0.03–3.29)	0.34
pM stage
M0	Reference		Reference
M1	4.01 (2.1–7.64)	<0.001*	2.39 (1.02–5.61)	0.04*
MX	1.75 (0.63–4.85)	0.28	6.2 (0.58–66.3)	0.13
Surgery
No	Reference		Reference
Yes	0.58 (0.35–0.96)	0.03*	0.7 (0.38–1.29)	0.25
Radiation
Yes	Reference
No	1.22 (0.74–2.02)	0.43
Histological type
SCC, NOS	Reference
TCC, NOS	1.2 (0.61–2.36)	0.6
Ac, NOS	1.83 (0.98–3.39)	0.06

Note:

* P<0.05.

Abbreviations: AJCC, American Joint Committee on Cancer; SCC, squamous cell carcinoma; TCC, transitional cell carcinoma; Ac, adenocarcinoma; NOS, not otherwise specified.

Table 4 Univariate and multivariate analysis of overall survival in men

	Univariate analysis		Multivariate analysis
	HR (95% CI)	P-value	HR (95% CI)	P-value
Year of diagnosis
2004–2008	Reference		Reference
2009–2013	0.66 (0.46–0.95)	0.03*	0.8 (0.55–1.17)	0.25
Age at diagnosis, years
0–54	Reference		Reference
55–64	0.72 (0.42–1.24)	0.23	0.96 (0.53–1.72)	0.88
65–74	0.91 (0.54–1.51)	0.71	1.31 (0.74–2.33)	0.36
75–84	1.85 (1.17–2.93)	0.01*	2.95 (1.69–5.15)	<0.001*
85+	1.75 (1.01–3.05)	0.046*	3.9 (1.98–7.67)	<0.001*
Race
White	1.63 (0.91–2.91)	0.1
Black	0.86 (0.33–2.23)	0.76
Other	1.68 (0.79–3.57)	0.18
Marital status
Not married	Reference		Reference
Married	0.71 (0.51–0.99)	0.04*	0.83 (0.58–1.2)	0.32
Unknown	0.41 (0.15–1.12)	0.08	0.33 (0.11–0.98)	0.045*
Grade
I and II	Reference
III	1.41 (0.92–2.15)	0.11
IV	1.11 (0.69–1.79)	0.67
Unknown	1.41 (0.85–2.35)	0.18
Tumor size, cm
≤2	Reference
>2 and ≤5	0.91 (0.5–1.63)	0.74
>5	0.77 (0.38–1.59)	0.48
Unknown	0.97 (0.57–1.65)	0.91
Positive-node status
0	Reference
1–3	0.69 (0.32–1.46)	0.33
>3	0.96 (0.32–2.89)	0.95
Unknown	0.86 (0.51–1.46)	0.58
AJCC stage
I	Reference		Reference
II	1.39 (0.82–2.36)	0.22	2.13 (0.77–5.9)	0.15
III and IV	1.87 (1.08–3.25)	0.03*	3.46 (1.36–8.82)	0.01*
Unknown	2.3 (1.31–4.04)	<0.001*	3.01 (1.09–8.3)	0.03*
pT stage
T0 and T1	Reference		Reference
T2	1.41 (0.91–2.19)	0.12	0.78 (0.33–1.85)	0.57
T3	2.26 (1.39–3.67)	<0.001*	0.79 (0.34–1.79)	0.57
T4 and TX	2.45 (1.56–3.84)	<,0.001*	0.91 (0.43–1.94)	0.8
pN stage
N0	Reference		Reference
N1	1.47 (0.92–2.34)	0.1	0.69 (0.37–1.27)	0.23
N2	1.37 (0.76–2.44)	0.29	0.91 (0.44–1.88)	0.8
NX	1.98 (1.22–3.22)	0.01*	0.58 (0.27–1.24)	0.16
pM stage
M0	Reference		Reference
M1	5.5 (3.64–8.33)	<0.001*	4.38 (2.5–7.67)	<0.001*
MX	2.14 (1.2–3.81)	0.01*	3.14 (1.19–8.24)	0.02*
Surgery
No	Reference		Reference
Yes	0.62 (0.44–0.88)	0.01*	0.7 (0.46–1.06)	0.09
Radiation
Yes	Reference
No	0.74 (1–0.39)	0.39
Histological type
SCC, NOS	Reference		Reference
TCC, NOS	1.78 (1.25–2.52)	<0.001*	1.17 (0.78–1.77)	0.45
Ac, NOS	1.15 (0.61–2.16)	0.67	0.81 (0.41–1.6)	0.55

Note:

* P<0.05.

Abbreviations: AJCC, American Joint Committee on Cancer; SCC, squamous cell carcinoma; TCC, transitional cell carcinoma; Ac, adenocarcinoma; NOS, not otherwise specified.

Table 5 Univariate and multivariate analysis of cancer-specific survival in men

	Univariate analysis		Multivariate analysis
	HR (95% CI)	P-value	HR (95% CI)	P-value
Year of diagnosis
2004–2008	Reference
2009–2013	0.66 (0.43–1)	0.05
Age at diagnosis, years
0–54	Reference
55–64	0.59 (0.32–1.08)	0.09
65–74	0.73 (0.42–1.3)	0.29
75–84	1.2 (0.71–2.01)	0.5
85+	1.09 (0.56–2.12)	0.79
Race
White	Reference
Black	1.28 (0.75–2.18)	0.36
Other	0.65 (0.24–1.76)	0.39
Marital status
Not married	Reference		Reference
Married	0.62 (0.42–0.91)	0.01*	0.77 (0.51–1.17)	0.22
Unknown	0.25 (0.06–1.05)	0.06	0.22 (0.05–0.97)	0.045*
Grade
I and II	Reference		Reference
III	2.04 (1.2–3.47)	0.01*	1.44 (0.78–2.67)	0.24
IV	1.42 (0.78–2.58)	0.25	0.83 (0.39–1.79)	0.64
Unknown	1.42 (0.73–2.76)	0.31	1.05 (0.49–2.25)	0.9
Tumor size, cm
≤2	Reference
>2 and ≤5	0.84 (0.42–1.66)	0.61
>5	0.72 (0.31–1.67)	0.45
Unknown	0.89 (0.48–1.65)	0.71
Positive-node status
0	Reference
1–3	0.72 (0.31–1.67)	0.45
>3	1.14 (0.37–3.54)	0.82
Unknown	0.74 (0.4–1.35)	0.33
AJCC stage
I	Reference		Reference
II	2.12 (1–4.49)	0.049*	2.09 (0.65–6.69)	0.22
III and IV	3.22 (1.53–6.78)	<0.001*	4.73 (1.59–14.04)	0.01*
Unknown	3.83 (1.79–8.19)	<0.001*	2.93 (0.9–9.52)	0.07
pT stage
T0 and T1	Reference		Reference
T2	1.87 (1.07–3.25)	0.03*	0.98 (0.41–2.35)	0.96
T3	2.97 (1.63–5.42)	<0.001*	0.7 (0.29–1.71)	0.44
T4 and TX	3.33 (1.9–5.84)	<0.001*	0.96 (0.44–2.14)	0.93
pN stage
N0	Reference		Reference
N1	1.94 (1.16–3.24)	0.01*	0.65 (0.33–1.27)	0.2
N2	1.9 (1.02–3.53)	0.04*	0.91 (0.41–2)	0.81
NX	2.22 (1.26–3.91)	0.01*	0.94 (0.41–2.15)	0.88
pM stage
M0	Reference		Reference
M1	7.5 (4.78–11.77)	<0.001*	3.52 (2.01–6.16)	<0.001*
MX	2.24 (1.12–4.48)	0.02*	2.12 (0.74–6.07)	0.16
Surgery
No	Reference		Reference
Yes	0.55 (0.37–0.82)	<0.001*	0.65 (0.41–1.04)	0.07
Radiation
Yes	Reference
No	1.03 (0.66–1.62)	0.88
Histological type
SCC, NOS	Reference		Reference
TCC, NOS	1.62 (1.08–2.42)	0.02*	1.72 (1–2.95)	0.05
Ac, NOS	0.62 (0.24–1.57)	0.31	0.78 (0.29–2.08)	0.62

Note:

* P<0.05.

Abbreviations: AJCC, American Joint Committee on Cancer; SCC, squamous cell carcinoma; TCC, transitional cell carcinoma; Ac, adenocarcinoma; NOS, not otherwise specified.