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The Association Between Race and 5-year Survival in Patients With Clear Cell Renal Cell Carcinoma: A Cohort Study

  • Author Footnotes
    # Authors contributed to this work equally.
    Dhaval Jivanji
    Correspondence
    Address correspondence to: Dhaval Jivanji, B.S., 2241 Malachite Drive, Lakeland, FL 33810.
    Footnotes
    # Authors contributed to this work equally.
    Affiliations
    Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
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  • Author Footnotes
    # Authors contributed to this work equally.
    Scott Jamieson
    Footnotes
    # Authors contributed to this work equally.
    Affiliations
    Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
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  • Author Footnotes
    # Authors contributed to this work equally.
    Chase Mallory
    Footnotes
    # Authors contributed to this work equally.
    Affiliations
    Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
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  • Vivian Wong
    Affiliations
    Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
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  • Sidney Barrau
    Affiliations
    Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
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  • Elias Atri
    Affiliations
    Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
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  • Grettel Castro
    Affiliations
    Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL
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  • Noël C. Barengo
    Affiliations
    Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL

    Faculty of Medicine, Riga Stradins University, Riga, Latvia

    Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
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  • Alan M. Nieder
    Affiliations
    Columbia University Division of Urology, Mount Sinai Medical Center, FL
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  • Author Footnotes
    # Authors contributed to this work equally.
Published:December 04, 2020DOI:https://doi.org/10.1016/j.urology.2020.10.055

      OBJECTIVE

      To determine if race was associated with 5-year cause-specific survival in patients with clear cell renal cell carcinoma.

      MATERIALS AND METHODS

      Outcomes were investigated using the Surveillance Epidemiology and End Results database with data from 13 states between the years 2007-2015. Covariates included age, sex, insurance, marital status, and tumor stage at diagnosis. Patients <18 years old or with missing data for race, survival time or insurance status were excluded. Cox regression models were used to determine associations through hazard ratios (HR) with 95% confidence intervals (CI) and to adjust for covariates.

      RESULTS

      A total of 8421 subjects were included in the analysis. After adjustment, there was no association between race and 5-year cause-specific survival in patients with ccRCC (Black- HR: 0.96, 95%CI: 0.83,1.12; American Indian/Alaskan- HR: 1.01, 95%CI: 0.75,1.36; Asian Pacific Islander- HR: 0.99, 95%CI: 0.82,1.12). Older individuals and those with regional or distant tumors showed an increased hazard of death, while females and insured patients showed decreased hazard.

      CONCLUSION

      Our study found that race was not associated with 5-year cause-specific survival from clear cell renal cell carcinoma. However inferior overall survival in Blacks with RCC has been well demonstrated in the literature. Our findings suggest that differences in survival may not be driven by cause-specific factors such as renal cell carcinoma, but rather social determinants of health which disproportionality affect Black patients. Further studies with more power that incorporate information on income, comorbidities, education status, and access to care are therefore necessary.
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