Abstract
Objective
To investigate association of African-American race and survival in Renal Cell Carcinoma
(RCC).
Patients and Methods
We queried the International Marker Consortium for Renal Cancer 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. Secondary outcome was cancer-specific mortality. Multivariable Analysis
and Kaplan-Meier Analysis were used to elucidate predictive factors and survival outcomes.
Results
Three thousand eight hundred and ninety-three patients were analyzed (AA, n = 564/NAA,
n = 3329). AA had greater Stage I (73.8% vs 63.9%, P <.001) and papillary RCC (29.8% vs 8.5%, P <.001). Multivariable Analysis revealed increasing age (HR = 1.03, P <.001), AA (HR = 1.24, P = .027), higher stage (HR = 1.30-3.19, P <.001), RN (HR = 2.45, P <.001), clear cell (HR = 1.23, P <.001), positive margin (HR = 1.34, P .004), and high-grade (HR = 1.58, P <.001) to be associated with worsened all-cause mortality. Increasing age (HR = 1.02,
P <.001), AA (HR = 1.48, P = .025), RN (HR = 2.98, P <.001), high-grade (HR = 3.11, P <.001), and higher stage (HR = 3.03-13.2, P <.001) were predictive for cancer-specific mortality. Kaplan-Meier Analysis revealed
worsened 5-year overall survival for AA in stage I (80% vs 88%, P = .001), stage III (26% vs 70%, P = .001), and stage IV (23% vs 44%, P = .009). Five-year cancer-specific survival was worse for AA in stage III (36% vs
81%, P <.001) and stage IV (30% vs 49%, P = .007).
Conclusion
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.
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Article info
Publication history
Published online: January 04, 2022
Accepted:
December 22,
2021
Received:
April 1,
2021
Footnotes
Source of Funding: Stephen Weissman Kidney Cancer Research Fund.
Identification
Copyright
© 2021 Published by Elsevier Inc.
