Race/Ethnicity Determines Life Expectancy in Surgically Treated T1aN0M0 Renal Cell Carcinoma Patients
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Race/Ethnicity Determines Life Expectancy in Surgically Treated T1aN0M0 Renal Cell Carcinoma Patients. / Würnschimmel, Christoph; Collà Ruvolo, Claudia; Nocera, Luigi; Wenzel, Mike; Tian, Zhe; Saad, Fred; Briganti, Alberto; Shariat, Shahrokh F; Mirone, Vincenzo; Chun, Felix K H; Tilki, Derya; Graefen, Markus; Karakiewicz, Pierre I.
in: EUR UROL FOCUS, Jahrgang 8, Nr. 1, 01.2022, S. 191-199.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Race/Ethnicity Determines Life Expectancy in Surgically Treated T1aN0M0 Renal Cell Carcinoma Patients
AU - Würnschimmel, Christoph
AU - Collà Ruvolo, Claudia
AU - Nocera, Luigi
AU - Wenzel, Mike
AU - Tian, Zhe
AU - Saad, Fred
AU - Briganti, Alberto
AU - Shariat, Shahrokh F
AU - Mirone, Vincenzo
AU - Chun, Felix K H
AU - Tilki, Derya
AU - Graefen, Markus
AU - Karakiewicz, Pierre I
N1 - Copyright © 2021 European Association of Urology. Published by Elsevier B.V. All rights reserved.
PY - 2022/1
Y1 - 2022/1
N2 - BACKGROUND: Life expectancy (LE) is an important consideration in the clinical decision-making for T1aN0M0 renal cell cancer (RCC) patients.OBJECTIVE: To test the effect of race/ethnicity (Caucasian, African American, Hispanic/Latino, and Asian) on LE predictions from Social Security Administration (SSA) life tables in male and female T1aN0M0 RCC patients.DESIGN, SETTING, AND PARTICIPANTS: We relied on the Surveillance, Epidemiology, and End Results database.INTERVENTION: Radical nephrectomy (RN) and partial nephrectomy (PN).OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Five-year and 10-yr observed overall survival (OS) of pT1aN0M0 RCC patients treated between 2004 and 2006 were compared with the LE predicted from SSA life tables. We repeated the comparison in a more contemporary cohort (2009-2011), with 5-yr follow-up and higher PN rates.RESULTS AND LIMITATIONS: In the 2004-2006 cohort, PN rate was 40.7%. OS followed the predicted LE in Caucasians, Hispanics/Latinos, and Asians, but not in African Americans, in whom 5-yr OS rates were 5.0% (male) and 8.7% (female) and 10-yr rates were 4.2% (male) and 11.1% (female) lower than predicted. In the 2009-2011 cohort, PN rate was 59.4%. Same observations were made for OS versus predicted LE in Caucasians, Hispanics/Latinos, and Asians. In African Americans, 5-yr OS rates were 1.5% (male) and 4.9% (female) lower than predicted.CONCLUSIONS: In RN- or PN-treated pT1aN0M0 RCC patients, LE predictions closely approximated OS of Caucasians, Hispanics/Latinos, and Asians. In African-American patients, SSA life tables overestimated LE, more in females than in males. The limitations of our study are its retrospective nature, its validity for US patients only, and the under-representation of racial/ethnic minorities.PATIENT SUMMARY: Social Security Administration life tables can be used to estimate long-term life expectancy in patients who are surgically treated for renal cancer (≤4 cm). However, while for Caucasians, Hispanics/Latinos, and Asians, the prediction performs well, life expectancy of African Americans is generally overestimated by life table predictions. TAKE HOME MESSAGE: In the clinical decision-making process for T1aN0M0 renal cell cancer patients eligible for radical or partial nephrectomy, the important influence of patient sex and race/ethnicity on life expectancy should be taken into account, when using Social Security Administration life tables.
AB - BACKGROUND: Life expectancy (LE) is an important consideration in the clinical decision-making for T1aN0M0 renal cell cancer (RCC) patients.OBJECTIVE: To test the effect of race/ethnicity (Caucasian, African American, Hispanic/Latino, and Asian) on LE predictions from Social Security Administration (SSA) life tables in male and female T1aN0M0 RCC patients.DESIGN, SETTING, AND PARTICIPANTS: We relied on the Surveillance, Epidemiology, and End Results database.INTERVENTION: Radical nephrectomy (RN) and partial nephrectomy (PN).OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Five-year and 10-yr observed overall survival (OS) of pT1aN0M0 RCC patients treated between 2004 and 2006 were compared with the LE predicted from SSA life tables. We repeated the comparison in a more contemporary cohort (2009-2011), with 5-yr follow-up and higher PN rates.RESULTS AND LIMITATIONS: In the 2004-2006 cohort, PN rate was 40.7%. OS followed the predicted LE in Caucasians, Hispanics/Latinos, and Asians, but not in African Americans, in whom 5-yr OS rates were 5.0% (male) and 8.7% (female) and 10-yr rates were 4.2% (male) and 11.1% (female) lower than predicted. In the 2009-2011 cohort, PN rate was 59.4%. Same observations were made for OS versus predicted LE in Caucasians, Hispanics/Latinos, and Asians. In African Americans, 5-yr OS rates were 1.5% (male) and 4.9% (female) lower than predicted.CONCLUSIONS: In RN- or PN-treated pT1aN0M0 RCC patients, LE predictions closely approximated OS of Caucasians, Hispanics/Latinos, and Asians. In African-American patients, SSA life tables overestimated LE, more in females than in males. The limitations of our study are its retrospective nature, its validity for US patients only, and the under-representation of racial/ethnic minorities.PATIENT SUMMARY: Social Security Administration life tables can be used to estimate long-term life expectancy in patients who are surgically treated for renal cancer (≤4 cm). However, while for Caucasians, Hispanics/Latinos, and Asians, the prediction performs well, life expectancy of African Americans is generally overestimated by life table predictions. TAKE HOME MESSAGE: In the clinical decision-making process for T1aN0M0 renal cell cancer patients eligible for radical or partial nephrectomy, the important influence of patient sex and race/ethnicity on life expectancy should be taken into account, when using Social Security Administration life tables.
U2 - 10.1016/j.euf.2021.02.004
DO - 10.1016/j.euf.2021.02.004
M3 - SCORING: Journal article
C2 - 33610487
VL - 8
SP - 191
EP - 199
JO - EUR UROL FOCUS
JF - EUR UROL FOCUS
SN - 2405-4569
IS - 1
ER -