Other-cause mortality and access to care in metastatic renal cell carcinoma according to race/ethnicity
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Other-cause mortality and access to care in metastatic renal cell carcinoma according to race/ethnicity. / Sorce, Gabriele; Hoeh, Benedikt; Hohenhorst, Lukas; Panunzio, Andrea; Tappero, Stefano; Tian, Zhe; Larcher, Alessandro; Capitanio, Umberto; Tilki, Derya; Terrone, Carlo; Chun, Felix K H; Antonelli, Alessandro; Saad, Fred; Shariat, Shahrokh F; Montorsi, Francesco; Briganti, Alberto; Karakiewicz, Pierre I.
in: UROL ONCOL-SEMIN ORI, Jahrgang 40, Nr. 11, 11.2022, S. 493.e9-493.e16.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Other-cause mortality and access to care in metastatic renal cell carcinoma according to race/ethnicity
AU - Sorce, Gabriele
AU - Hoeh, Benedikt
AU - Hohenhorst, Lukas
AU - Panunzio, Andrea
AU - Tappero, Stefano
AU - Tian, Zhe
AU - Larcher, Alessandro
AU - Capitanio, Umberto
AU - Tilki, Derya
AU - Terrone, Carlo
AU - Chun, Felix K H
AU - Antonelli, Alessandro
AU - Saad, Fred
AU - Shariat, Shahrokh F
AU - Montorsi, Francesco
AU - Briganti, Alberto
AU - Karakiewicz, Pierre I
N1 - Copyright © 2022 Elsevier Inc. All rights reserved.
PY - 2022/11
Y1 - 2022/11
N2 - BACKGROUND: We tested for other-cause mortality (OCM) differences according to race/ethnicity in metastatic renal cell carcinoma (mRCC). Such differences may affect treatment considerations.METHODS: Within the Surveillance, Epidemiology, and End Results Research Plus repository (2000-2018), we identified clear cell (ccmRCC) and non-clear cell (non-ccmRCC) mRCC patients and stratified according to race/ethnicity: Caucasian vs. Hispanic vs. African American vs. Asian. Poisson smoothed cumulative incidence plots and competing risks regression (CRR) models addressing OCM, after adjustment for cancer-specific mortality , were fitted. Subsequently, multivariable logistic regression models tested access to cytoreductive nephrectomy (CNT) and systemic therapy (ST).RESULTS: Of 10,958 ccmRCC patients, 7,892 (72%), 1,743 (16%), 688 (6%), and 635 (6%) were Caucasian, Hispanic, African American, and Asian, respectively. Of 1,239 non-ccmRCC patients, 799 (64%), 106 (9%), 278 (22%), and 56 (5%) were Caucasian, Hispanic, African American, and Asian, respectively. In multivariable CRR models, OCM was higher in African Americans vs. Caucasians in ccmRCC (HR:1.55; CI:1.19-2.01; P < 0.001) and in non-ccmRCC (HR:1.54; CI:1.01-2.35; P = 0.04). In multivariable logistic regression models, African Americans with ccmRCC were less likely to undergo CNT (OR:0.72, CI:0.60-0.86; P < 0.001), but more likely to undergo ST (OR:1.34, CI:1.11-1.61; P = 0.002).CONCLUSIONS: In this retrospective analysis, African Americans with ccmRCC and non-ccmRCC exhibited higher OCM than Caucasians. Based on higher OCM, African Americans were less likely to undergo CNT, but more likely to benefit from ST.
AB - BACKGROUND: We tested for other-cause mortality (OCM) differences according to race/ethnicity in metastatic renal cell carcinoma (mRCC). Such differences may affect treatment considerations.METHODS: Within the Surveillance, Epidemiology, and End Results Research Plus repository (2000-2018), we identified clear cell (ccmRCC) and non-clear cell (non-ccmRCC) mRCC patients and stratified according to race/ethnicity: Caucasian vs. Hispanic vs. African American vs. Asian. Poisson smoothed cumulative incidence plots and competing risks regression (CRR) models addressing OCM, after adjustment for cancer-specific mortality , were fitted. Subsequently, multivariable logistic regression models tested access to cytoreductive nephrectomy (CNT) and systemic therapy (ST).RESULTS: Of 10,958 ccmRCC patients, 7,892 (72%), 1,743 (16%), 688 (6%), and 635 (6%) were Caucasian, Hispanic, African American, and Asian, respectively. Of 1,239 non-ccmRCC patients, 799 (64%), 106 (9%), 278 (22%), and 56 (5%) were Caucasian, Hispanic, African American, and Asian, respectively. In multivariable CRR models, OCM was higher in African Americans vs. Caucasians in ccmRCC (HR:1.55; CI:1.19-2.01; P < 0.001) and in non-ccmRCC (HR:1.54; CI:1.01-2.35; P = 0.04). In multivariable logistic regression models, African Americans with ccmRCC were less likely to undergo CNT (OR:0.72, CI:0.60-0.86; P < 0.001), but more likely to undergo ST (OR:1.34, CI:1.11-1.61; P = 0.002).CONCLUSIONS: In this retrospective analysis, African Americans with ccmRCC and non-ccmRCC exhibited higher OCM than Caucasians. Based on higher OCM, African Americans were less likely to undergo CNT, but more likely to benefit from ST.
KW - Humans
KW - Carcinoma, Renal Cell/pathology
KW - Kidney Neoplasms/pathology
KW - Ethnicity
KW - Retrospective Studies
KW - SEER Program
KW - Health Services Accessibility
U2 - 10.1016/j.urolonc.2022.06.022
DO - 10.1016/j.urolonc.2022.06.022
M3 - SCORING: Journal article
C2 - 35907705
VL - 40
SP - 493.e9-493.e16
JO - UROL ONCOL-SEMIN ORI
JF - UROL ONCOL-SEMIN ORI
SN - 1078-1439
IS - 11
ER -