To test whether race/ethnicity affects stage or grade distribution at upper tract urothelial carcinoma (UTUC) diagnosis.
Within the Surveillance, Epidemiology, and End Results (SEER) database 2004-2020, UTUC patients were identified. Multivariable logistic regression models tested for the association between race/ethnicity and stage as well as grade at diagnosis according to renal pelvis vs. ureteral origin. Stage at presentation was defined as (i) metastatic stage (TanyNanyM1) and (ii) advanced stage (locoregional or metastatic (T3-4N0-2M0-1)).
Of 14,384 UTUC patients, 8926 (62%) were renal pelvis. Of renal pelvis UTUC patients, 7064 (79%) were Caucasian, 797 (9%) Hispanic, 623 (7%) Asian Pacific Islander (API), and 442 (5%) African American (AA). Relative to Caucasians, API (odd ratio (OR) 1.85, 95% confidence interval (CI) 1.44-2.37, p < 0.001) and AA (OR 1.37, 95% CI 1.02-1.83, p = 0.03) patients more frequently harbored metastatic stage. APIs also more frequently harbored advanced (OR 1.33, 95% CI 1.11-1.60, p = 0.002) stage and high (OR 1.33, 95% CI 1.07-1.67, p = 0.01) grade. Of 5458 (38%) ureteral UTUC patients, 4360 (80%) were Caucasian, 362 (7%) Hispanic, 509 (9%) API, and 227 (4%) AA. Relative to Caucasians, Hispanic (OR 1.45, 95% CI 1.01-2.05, p = 0.03) patients more frequently harbored metastatic stage. APIs also more frequently harbored advanced stage (OR 1.22, 95% CI 1.02-1.47, p = 0.03) and high (OR 1.94, 95% CI 1.49-2.55, p < 0.001) grade.
Race/ethnicity other than Caucasian, such as API and Hispanic, may predispose to higher odds of metastatic (TanyNanyM1) or advanced (T3-4N0-2M0-1) stages as well as to higher grade at initial diagnosis.
Journal of racial and ethnic health disparities. 2025 Jan 09 [Epub ahead of print]
Francesco Di Bello, Mario de Angelis, Carolin Siech, Natali Rodriguez Peñaranda, Zhe Tian, Jordan A Goyal, Claudia Collà Ruvolo, Gianluigi Califano, Massimiliano Creta, Fred Saad, Shahrokh F Shariat, Alberto Briganti, Felix K H Chun, Salvatore Micali, Nicola Longo, Pierre I Karakiewicz
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada. ., Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada., Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Via Pansini, 80131, Naples, Italy., Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria., Vita-Salute San Raffaele University, Milan, Italy., Department of Urology, University Hospital, Goethe University Frankfurt, Frankfurt Am Main, Germany., Department of Urology, Ospedale Policlinico E Nuovo Ospedale Civile S. Agostino Estense Modena, University of Modena and Reggio Emilia, Modena, Italy.