Wilms tumor (WT) poses a cancer health disparity to black children globally, which has not been evaluated thoroughly for other pediatric renal cancers. We aimed to characterize health disparities among Tennessee children treated for any renal cancer.
The Tennessee Cancer Registry (TCR) was queried for patients ≤18 years having any renal cancer (n = 160). To clarify treatment and outcomes, we performed a retrospective cohort study of pediatric renal cancer patients in our institutional cancer registry (ICR; n = 121). Diagnoses in both registries included WT, Sarcoma/Other, and Renal Cell Carcinoma. Wilcoxon/Pearson, Kaplan-Meier, and logistic regression were completed.
In both registries, WT comprised the most common renal cancer and youngest median age. Sarcoma was intermediate in frequency and age, and RCC was least common, having the oldest age (p < 0.001). In the TCR, black patients comprised 26% of all patients, presented more commonly with distant disease than white patients (37% v. 16%; p = 0.021), and showed worse overall survival (73% v. 89%; p = 0.018), while the ICR showed similar survival between race groups (92% v. 93%, p = 0.868). Sarcoma and metastases were independent predictors of death in both registries (p ≤ 0.002).
Black children in Tennessee presented with more advanced disease and experienced worse survival when combining all renal cancer types, particularly RCC and Sarcoma. When treated at a comprehensive pediatric cancer center, these survival disparities appear diminished.
Prognostic study.
Level II (retrospective cohort).
Journal of pediatric surgery. 2020 Feb 28 [Epub ahead of print]
Kevin Neuzil, Annie Apple, Amelia Sybenga, Heidi Chen, Shilin Zhao, Martin Whiteside, Hernan Correa, Hannah M Phelps, Harold N Lovvorn
School of Medicine, Vanderbilt University Medical Center, 1611 21(st) Avenue South, Nashville, TN; Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, 2200 Children's Way, Nashville, TN. Electronic address: ., School of Medicine, Vanderbilt University Medical Center, 1611 21(st) Avenue South, Nashville, TN; Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, 2200 Children's Way, Nashville, TN., Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, 2200 Children's Way, Nashville, TN., Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, 2200 Children's Way, Nashville, TN; Department of Biostatistics, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN., Tennessee Cancer Registry, Tennessee Department of Health, 710 James Robertson Parkway, Nashville, TN., School of Medicine, Vanderbilt University Medical Center, 1611 21(st) Avenue South, Nashville, TN; Department of General Surgery, Washington University in St. Louis, 4590 Children's Place, St. Louis, MO., Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, 2200 Children's Way, Nashville, TN; Department of Pediatric Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN.