636 RACIAL DISPARITIES IN KIDNEY CANCER TREATMENT AND SURVIVAL (2013)

You have accessJournal of UrologyKidney Cancer: Evaluation & Staging (I)1 Apr 2013636 RACIAL DISPARITIES IN KIDNEY CANCER TREATMENT AND SURVIVAL Benjamin Powers, Laura Giusto, Adam Davey, Alliric Willis, Robert Uzzo, and Marc Smaldone Benjamin PowersBenjamin Powers Philadelphia, PA , Laura GiustoLaura Giusto Philadelphia, PA , Adam DaveyAdam Davey Philadelphia, PA , Alliric WillisAlliric Willis Philadelphia, PA , Robert UzzoRobert Uzzo Philadelphia, PA , and Marc SmaldoneMarc Smaldone Philadelphia, PA View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.188AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Racial disparities in kidney cancer survival have been documented between Whites and African Americans (AA). We aimed to evaluate racial disparities in kidney cancer treatment and survival using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program. METHODS The SEER database was queried for malignant neoplasms of the kidney, excluding renal pelvis tumors, from 2000-08. Differences in treatment were compared using multinomial logistic regression (LR) with radical nephrectomy as referent, and differences in overall survival were assessed using Kaplan-Meier and Cox proportional hazard regression. RESULTS 50,125 cases were analyzed and classified as 25,065 (70.7%) White, 5,358 (15.1%) Hispanic, 2,902 (8.2%) AA, and 2,108 (5.9%) Asian-American Pacific-Islander (AAPI) respectively. LR demonstrated that AA patients were significantly more likely to receive no surgical intervention (RRR 1.74) compared to White patients though no differences were seen for ablation or partial nephrectomy (PN). Hispanic patients were less likely to receive PN (RRR 0.80) compared to White patients but no differences were observed for ablation. There was no difference in treatment between AAPIs and White patients. Unadjusted median survival was significantly different between race groupings: Whites 60.0, AAs 56.0, AAPIs 52.0 and Hispanics 51.0 months (p<0.01). Multivariable analysis revealed higher mortality for AAs (HR 1.15, [CI 1.09-1.22]) compared to Whites when stratified for gender, age, surgery, grade, and AJCC 6th edition stage and adjusted for histology and year of diagnosis. AAPIs (HR 0.82, [CI 0.76-0.88]) and Hispanics (HR 0.94, [CI 0.90-0.99]) demonstrated significantly lower mortality compared to White patients. CONCLUSIONS Our analyses demonstrate that significant racial disparities exist regarding kidney cancer treatment and survival using SEER data. Most notably, AA patients with kidney cancer were more likely to receive no surgical intervention and were more likely to die compared to White patients. While these findings suggest that race may significantly influence kidney cancer treatment practice patterns and survival, further studies are warranted to better elucidate the role of racial disparities in kidney cancer to guide public health and policy action. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e260 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benjamin Powers Philadelphia, PA More articles by this author Laura Giusto Philadelphia, PA More articles by this author Adam Davey Philadelphia, PA More articles by this author Alliric Willis Philadelphia, PA More articles by this author Robert Uzzo Philadelphia, PA More articles by this author Marc Smaldone Philadelphia, PA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...