The South Texas region, with a predominantly Latinx population, has a very high incidence of renal cell carcinoma (RCC), including those with tumor extending into the major blood vessels called venous tumor thrombus (VTT). There is currently no data on outcomes of Latinx patients with VTT as most published studies are from predominantly Caucasian population. Therefore, we performed this study to fill an urgent, unmet need. We reviewed patients who underwent radical nephrectomy with removal of VTT (called tumor thrombectomy) between 2015 and 2020. We collected data on demographics, clinical, pathological characteristics and outcomes of patients. Univariate and multivariate Cox regression analyses were used to evaluate the associations between ethnicity and disease progression or survival. We identified 112 patients, of which 67 (62%) were Latinx, and 41 (38%) were non-Latinx. Approximately 60% of patients had Level II-IV VTT; Latinx presented with a higher level of tumor thrombus (p=0.046). Latinx patients had a higher rate of no insurance (11% vs. 27%, p=0.04) and were more likely to lost to follow-up after surgery (22.4% vs. 13.3%, p=0.23) compared to non-Latinx. Fewer Latinx received systemic therapy (28% vs. 42%; p=0.13). Ninety-day mortality for the entire cohort was 3.8%. The Latinx population in the South Texas region present late, with advanced thrombus level, and do not have access to systemic therapy. Given symptomatic disease, surgical treatment, if feasible, is their only option. Our results highlight disparate treatment patterns which require further investigation and health-care policy changes.
Kidney cancer journal : official journal of the Kidney Cancer Association. 2022 Mar 17 [Epub]
Furkan Dursun, Rahul S Patel, Dawn Hui, Hanzhang Wang, Ahmed Mansour, Deepak Pruthi, David G Alonso, Lalithapriya Jayakumar, Ronald Rodriguez, Robert S Svatek, Michael A Liss, Dharam Kaushik
Department of Urology, University of Texas Health San Antonio, TX, USA., Department of Cardiothoracic Surgery, University of Texas Health San Antonio, TX, USA., Department of Urology, University of Texas Rio Grande Valley, TX, USA., Department of Surgery, Division of Vascular & Endovascular Surgery, University of Texas Health San Antonio, TX, USA.