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

S. Luzzago, C. Palumbo, G. Rosiello, S. Knipper, A. Pecoraro, S. Nazzani, Z. Tian, G. Musi, E. Montanari, S.F. Shariat, F. Saad, A. Briganti, O. de Cobelli, P.I. Karakiewicz

Research output: Contribution to journalArticlepeer-review

Abstract

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. © 2020, Springer Nature Switzerland AG.
Original languageEnglish
Pages (from-to)263-272
Number of pages10
JournalCancer Causes Control
Volume31
Issue number3
DOIs
Publication statusPublished - 2020

Keywords

  • African-American
  • Caucasian
  • Cytoreductive nephrectomy
  • Hispanic
  • Metastatic renal cell carcinoma
  • Systemic therapy
  • adult
  • African American
  • aged
  • Article
  • cancer mortality
  • cancer patient
  • cancer registry
  • cancer staging
  • cancer survival
  • cancer therapy
  • combination chemotherapy
  • controlled study
  • cytoreductive nephrectomy
  • descriptive research
  • ethnic difference
  • female
  • histopathology
  • human
  • human tissue
  • Kaplan Meier method
  • kidney metastasis
  • major clinical study
  • male
  • multivariate analysis
  • nephrectomy
  • non clear cell metastatic renal cell carcinoma
  • priority journal
  • proportional hazards model
  • race difference
  • renal cell carcinoma
  • sex difference
  • survival rate
  • systemic therapy
  • tumor volume
  • comparative study
  • epidemiology
  • ethnology
  • Italy
  • kidney
  • kidney tumor
  • metastasis
  • middle aged
  • mortality
  • pathology
  • African Americans
  • Aged
  • Carcinoma, Renal Cell
  • European Continental Ancestry Group
  • Female
  • Hispanic Americans
  • Humans
  • Kidney
  • Kidney Neoplasms
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Proportional Hazards Models
  • Survival Rate

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