Sex differences in disease presentation, surgical and oncological outcome of hepatic resection for primary and metastatic liver tumours

Background:

In the last decade sex differences became of rising interest in many fields of medicine. Although disease presentation of various cancers varies by sex, it remains unknown whether sex has a role in the postoperative and long-term outcome of patients following hepatic resection (HR).

Methods:

Retrospective analysis of 375 patients who underwent HR for malignancy at Innsbruck Medical University. Demographic, pathological and postoperative parameters and survival data were obtained from a prospective database. Univariate analysis was used to identify sex differences for the entire cohort and for sub-cohorts stratified by age, tumour stage and tumour entity. Kaplan-Meier method was used for survival analysis.

Results:

The cohort consisted of 170 female and 205 male patients. Women were characterized by younger age (p = 0.024), lower rate of cardiac comorbidities (p = 0.001), diabetes (p = 0.008) and obesity (p = 0.008). Type and extent of HR and surgical management did not vary by sex. The 90-day morbidity (p = 0.802) and 90-day mortality (p = 0.702) were comparable. No differences in disease-free – and overall survival related to sex could be identified, neither for the entire cohort nor for the sub-cohorts.

Conclusion:

Although male sex has long been known to be a risk factor for various cancers, no significant sex differences in disease presentation, perioperative and long-term outcome could be identified, except younger age and less comorbidities in women. Female sex is not an independent predictor for survival following HR for malignancy.