1113 THE EFFECT OF RACE AND GENDER ON THE SURGICAL MANAGEMENT OF THE SMALL RENAL MASS

Field: Medicine (Health Sciences)

You have accessJournal of UrologyKidney Cancer: Localized I1 Apr 20121113 THE EFFECT OF RACE AND GENDER ON THE SURGICAL MANAGEMENT OF THE SMALL RENAL MASS Max Kates, Michael Whalen, Gina Badalato, and James McKiernan Max KatesMax Kates New York, NY More articles by this author , Michael WhalenMichael Whalen New York, NY More articles by this author , Gina BadalatoGina Badalato New York, NY More articles by this author , and James McKiernanJames McKiernan New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1221AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES For patients diagnosed with a small renal mass, partial nephrectomy (PN) has become increasingly utilized over the past decade, largely due to data that suggest PN confers similar cancer control and preserves renal function in comparison to radical nephrectomy. However, partial nephrectomy has historically been used preferentially in certain demographic groups. We thus sought to characterize the racial and gender differences in the surgical management of T1a RCC over the most recent available 10 year period in the United States. METHODS The Surveillance, Epidemiology, and End Results (SEER) registry was queried for patients with T1a renal cell carcinoma (RCC) treated over the most recent decade, 1998-2007. Baseline socio-demographic data was compared between Caucasian and African-American (AA) patients using chi-square and t-test analysis, and rates of radical nephrectomy (RN) were compared for all permutations of race and gender. A multivariate logistic regression model was in turn created with these variables to predict the odds of undergoing a radical nephrectomy. No prior assumptions were made regarding superiority of PN over RN as a therapeutic intervention. RESULTS A total of 14,953 patients were eligible for inclusion in this study, and of these 1,804 (12%) were African-American. Comparably, AA patients were younger (<50 years; 23 vs 28%, p<0.001), and had an increased rate of high grade disease (13 vs 16%, p<0.001). Among different subsets of race and gender, AA women received PN least often (28%) compared to all other groups, with AA women at a 47% increased risk of undergoing RN as compared to Caucasian male counterparts (95% CI: 1.24-1.73). CONCLUSIONS Significant racial and gender disparities exist with regard to utilization of nephron-sparing surgery for small renal masses, particularly in AA women. Further efforts should be directed to elucidating and addressing the rationale behind this disparity to ensure the uniformity of care. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e451 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Max Kates New York, NY More articles by this author Michael Whalen New York, NY More articles by this author Gina Badalato New York, NY More articles by this author James McKiernan New York, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...