Effect of African-American race on cancer specific mortality differs according to clear cell vs. non-clear cell histologic subtype in metastatic renal cell carcinoma

Michele Marchioni, SS Harmouch, S Nazzani, Marco Bandini, F Preisser, Z Tian, A Kapoor, L Cindolo, A Briganti, SF Shariat, L Schips, PI Karakiewicz

Research output: Contribution to journalArticle

Abstract

Aim: To test the effect of African-American race on cancer specific mortality (CSM) in clear cell metastatic renal cell carcinoma (ccmRCC) and non-ccmRCC. Patients and methods: Within Surveillance, Epidemiology and End Results registry (2001–2014), we identified patients with ccmRCC and non-ccmRCC. We relied on propensity score (PS) matching to reduce the effect of inherent differences between African-American vs. Caucasian patients. After PS matching that included access to cytoreductive nephrectomy (CNT), cumulative incidence, competing-risks regression (CRR) models and landmark analyses tested the effect of race on CSM. Results: Before PS matching, African-American patients accounted for 7.0 and 24.5% of respectively ccmRCC (N = 6742) and non-ccmRCC patients (N = 766). After PS matching, African-American patients accounted for 22.3 and 33.5% of respectively ccmRCC (N = 2050) and non-ccmRCC (N = 391) matched cohorts. In multivariable CRR models focusing on ccmRCC, higher CSM was recorded in African-Americans (HR:1.27, p < 0.001). Conversely, in non-ccmRCC, lower CSM was recorded in African-Americans (HR:0.54, p < 0.001). Landmark analyses rejected the hypothesis of immortal time bias. Conclusion: African-Americans experienced higher CSM in ccmRCC. Conversely, African-Americans experienced lower CSM, when diagnosed with non-ccmRCC. These differences are independent of access to CNT and warrant further study since they may have an impact on efficacy or access to systemic therapies. © 2018 Elsevier Ltd
Original languageEnglish
Pages (from-to)112-118
Number of pages7
JournalCancer Epidemiology
Volume54
Issue number6
DOIs
Publication statusPublished - 2018

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Renal Cell Carcinoma
African Americans
Propensity Score
Mortality
Neoplasms
Nephrectomy
Registries
Clear-cell metastatic renal cell carcinoma
Epidemiology
Incidence

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Effect of African-American race on cancer specific mortality differs according to clear cell vs. non-clear cell histologic subtype in metastatic renal cell carcinoma. / Marchioni, Michele; Harmouch, SS; Nazzani, S; Bandini, Marco; Preisser, F; Tian, Z; Kapoor, A; Cindolo, L; Briganti, A; Shariat, SF; Schips, L; Karakiewicz, PI.

In: Cancer Epidemiology, Vol. 54, No. 6, 2018, p. 112-118.

Research output: Contribution to journalArticle

Marchioni, M, Harmouch, SS, Nazzani, S, Bandini, M, Preisser, F, Tian, Z, Kapoor, A, Cindolo, L, Briganti, A, Shariat, SF, Schips, L & Karakiewicz, PI 2018, 'Effect of African-American race on cancer specific mortality differs according to clear cell vs. non-clear cell histologic subtype in metastatic renal cell carcinoma', Cancer Epidemiology, vol. 54, no. 6, pp. 112-118. https://doi.org/10.1016/j.canep.2018.04.006
Marchioni, Michele ; Harmouch, SS ; Nazzani, S ; Bandini, Marco ; Preisser, F ; Tian, Z ; Kapoor, A ; Cindolo, L ; Briganti, A ; Shariat, SF ; Schips, L ; Karakiewicz, PI. / Effect of African-American race on cancer specific mortality differs according to clear cell vs. non-clear cell histologic subtype in metastatic renal cell carcinoma. In: Cancer Epidemiology. 2018 ; Vol. 54, No. 6. pp. 112-118.
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T1 - Effect of African-American race on cancer specific mortality differs according to clear cell vs. non-clear cell histologic subtype in metastatic renal cell carcinoma

AU - Marchioni, Michele

AU - Harmouch, SS

AU - Nazzani, S

AU - Bandini, Marco

AU - Preisser, F

AU - Tian, Z

AU - Kapoor, A

AU - Cindolo, L

AU - Briganti, A

AU - Shariat, SF

AU - Schips, L

AU - Karakiewicz, PI

PY - 2018

Y1 - 2018

N2 - Aim: To test the effect of African-American race on cancer specific mortality (CSM) in clear cell metastatic renal cell carcinoma (ccmRCC) and non-ccmRCC. Patients and methods: Within Surveillance, Epidemiology and End Results registry (2001–2014), we identified patients with ccmRCC and non-ccmRCC. We relied on propensity score (PS) matching to reduce the effect of inherent differences between African-American vs. Caucasian patients. After PS matching that included access to cytoreductive nephrectomy (CNT), cumulative incidence, competing-risks regression (CRR) models and landmark analyses tested the effect of race on CSM. Results: Before PS matching, African-American patients accounted for 7.0 and 24.5% of respectively ccmRCC (N = 6742) and non-ccmRCC patients (N = 766). After PS matching, African-American patients accounted for 22.3 and 33.5% of respectively ccmRCC (N = 2050) and non-ccmRCC (N = 391) matched cohorts. In multivariable CRR models focusing on ccmRCC, higher CSM was recorded in African-Americans (HR:1.27, p < 0.001). Conversely, in non-ccmRCC, lower CSM was recorded in African-Americans (HR:0.54, p < 0.001). Landmark analyses rejected the hypothesis of immortal time bias. Conclusion: African-Americans experienced higher CSM in ccmRCC. Conversely, African-Americans experienced lower CSM, when diagnosed with non-ccmRCC. These differences are independent of access to CNT and warrant further study since they may have an impact on efficacy or access to systemic therapies. © 2018 Elsevier Ltd

AB - Aim: To test the effect of African-American race on cancer specific mortality (CSM) in clear cell metastatic renal cell carcinoma (ccmRCC) and non-ccmRCC. Patients and methods: Within Surveillance, Epidemiology and End Results registry (2001–2014), we identified patients with ccmRCC and non-ccmRCC. We relied on propensity score (PS) matching to reduce the effect of inherent differences between African-American vs. Caucasian patients. After PS matching that included access to cytoreductive nephrectomy (CNT), cumulative incidence, competing-risks regression (CRR) models and landmark analyses tested the effect of race on CSM. Results: Before PS matching, African-American patients accounted for 7.0 and 24.5% of respectively ccmRCC (N = 6742) and non-ccmRCC patients (N = 766). After PS matching, African-American patients accounted for 22.3 and 33.5% of respectively ccmRCC (N = 2050) and non-ccmRCC (N = 391) matched cohorts. In multivariable CRR models focusing on ccmRCC, higher CSM was recorded in African-Americans (HR:1.27, p < 0.001). Conversely, in non-ccmRCC, lower CSM was recorded in African-Americans (HR:0.54, p < 0.001). Landmark analyses rejected the hypothesis of immortal time bias. Conclusion: African-Americans experienced higher CSM in ccmRCC. Conversely, African-Americans experienced lower CSM, when diagnosed with non-ccmRCC. These differences are independent of access to CNT and warrant further study since they may have an impact on efficacy or access to systemic therapies. © 2018 Elsevier Ltd

U2 - 10.1016/j.canep.2018.04.006

DO - 10.1016/j.canep.2018.04.006

M3 - Article

VL - 54

SP - 112

EP - 118

JO - Cancer Epidemiology

JF - Cancer Epidemiology

SN - 1877-7821

IS - 6

ER -