Racial and ethnic differences in survival in contemporary metastatic renal cell carcinoma patients, according to alternative treatment modalities

Stefano Luzzago, Carlotta Palumbo, Giuseppe Rosiello, Sophie Knipper, Angela Pecoraro, Sebastiano Nazzani, Zhe Tian, Gennaro Musi, Emanuele Montanari, Shahrokh F. Shariat, Fred Saad, Alberto Briganti, Ottavio de Cobelli, Pierre I. Karakiewicz

Research output: Contribution to journalArticle


Purpose: To test the association between African-American race and overall mortality (OM) rates in patients with metastatic renal cell carcinoma (mRCC). Methods: Within the Surveillance, Epidemiology, and End Results registry (2006–2015), we identified patients with clear cell (ccmRCC) and non-clear cell mRCC (non-ccmRCC). African-Americans, Caucasians, and Hispanics were identified. Stratification was made according to histology and treatments: (1) no treatment, (2) systemic therapy (ST), (3) cytoreductive nephrectomy (CNT), (4) CNT + ST. Kaplan–Meier plots and multivariable Cox regression analyses were used. Results: Of ccmRCC patients, 410 (7%), 4353 (75%), and 1005 (17%) were African-American, Caucasian, and Hispanic, respectively. Of non-ccmRCC patients, 183 (25%), 479 (65%), and 77 (10%) were African-American, Caucasian, and Hispanic, respectively. In ccmRCC, African-Americans were associated with higher OM rates (HR 1.20; 95% CI 1.05–1.37). Conversely, in non-ccmRCC, African-Americans were associated with lower OM rates (HR 0.75; 95% CI 0.59–0.97). Conclusion: African-American race is associated with prolonged survival in non-ccmRCC, but it is also associated with lower survival rates in ccmRCC. The exception to these observations consisted of patients treated with combination of CNT + ST for either ccmRCC or non-ccmRCC.

Original languageEnglish
JournalCancer Causes and Control
Publication statusAccepted/In press - Jan 1 2020



  • African-American
  • Caucasian
  • Cytoreductive nephrectomy
  • Hispanic
  • Metastatic renal cell carcinoma
  • Systemic therapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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