To investigate association of African-American race and survival in Renal Cell Carcinoma (RCC).
We queried the International Marker Consortium for Renal Cancer (INMARC) database for patients who underwent partial or radical (RN) nephrectomy. The cohort was divided into African American (AA) and Non-African American (NAA) patients. Primary outcome was all-cause mortality (ACM). Secondary outcome was cancer-specific mortality (CSM). Multivariable Analysis (MVA) and Kaplan-Meier Analysis (KMA) were used to elucidate predictive factors and survival outcomes.
3893 patients were analyzed (AA, n=564/NAA, n=3329). AA had greater Stage I (73.8% vs. 63.9%, p<0.001) and papillary RCC (29.8% vs. 8.5%, p<0.001). MVA revealed increasing age (HR=1.03, p<0.001), AA (HR=1.24, p=0.027), higher stage (HR=1.30-3.19, p<0.001), RN (HR=2.45, p<0.001), clear cell (HR=1.23, p<0.001), positive margin (HR=1.34, p 0.004), and high-grade (HR=1.58, p<0.001) to be associated with worsened ACM. Increasing age (HR=1.02, p<0.001), AA (HR=1.48, p=0.025), RN (HR=2.98, p<0.001), high-grade (HR=3.11, p<0.001), and higher stage (HR=3.03-13.2, p<0.001) were predictive for CSM. KMA revealed worsened 5-year overall survival for AA in stage I (80% vs 88%, p=0.001), stage III (26% vs. 70%, p=0.001), and stage IV (23% vs. 44%, p=0.009). 5-year cancer-specific survival was worse for AA in stage III (36% vs. 81%, p<0.001) and stage IV (30% vs. 49%, p=0.007).
Despite presenting with more indolent histology and lower stage, African-Americans were at greater risk for diminished survival, faring worse in overall survival for all stages and cancer-specific survival in for stage III/IV RCC. Further investigation into factors associated with these disparities is warranted.
Urology. 2022 Jan 04 [Epub ahead of print]
Margaret F Meagher, Dattatraya Patil, Kazutaka Saito, Juan F Javier-Desloges, Aaron W Bradshaw, Sunil H Patel, Brittney H Cotta, Yosuke Yasuda, Ahmed Eldefrawy, Fady Ghali, Ryan Nasseri, Fang Wan, Yasuhisa Fujii, Viraj Master, Ithaar H Derweesh
Department of Urology, UC San Diego School of Medicine, La Jolla, USA., Department of Urology, Emory University, Atlanta, USA., Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan., Department of Urology, UC San Diego School of Medicine, La Jolla, USA. Electronic address: .