Disparities in Cancer Specific and Overall Survival Outcomes in African Americans With Renal Cell Carcinoma: Analysis From the International Marker Consortium for Renal Cancer(INMARC)

OBJECTIVETo investigate association of African-American race and survival in Renal Cell Carcinoma(RCC).PATIENTS ANDMETHODSWe queried the International Marker Consortium for Renal Cancer database for patients whounderwent partial or radical (RN) nephrectomy. The cohort was divided into African American(AA) and non-African American (NAA) patients. Primary outcome was all-cause mortality. Sec-ondary outcome was cancer-specific mortality. Multivariable Analysis and Kaplan-Meier Analysiswere used to elucidate predictive factors and survival outcomes.RESULTSThree thousand eight hundred and ninety-three patients were analyzed (AA, n = 564/NAA,n = 3329). AA had greater Stage I (73.8% vs 63.9%,P<.001) and papillary RCC (29.8% vs 8.5%,P<.001). Multivariable Analysis revealed increasing age (HR = 1.03,P<.001), AA (HR = 1.24,P= .027), higher stage (HR = 1.30-3.19,P<.001), RN (HR = 2.45,P<.001), clear cell(HR = 1.23,P<.001), positive margin (HR = 1.34,P.004), and high-grade (HR = 1.58,P<.001)to be associated with worsened all-cause mortality. Increasing age (HR = 1.02,P<.001), AA(HR = 1.48,P= .025), RN (HR = 2.98,P<.001), high-grade (HR = 3.11,P<.001), and higherstage (HR = 3.03-13.2,P<.001) were predictive for cancer-specific mortality. Kaplan-Meier Analy-sis revealed worsened 5-year overall survival for AA in stage I (80% vs 88%,P= .001), stage III(26% vs 70%,P= .001), and stage IV (23% vs 44%,P= .009). Five-year cancer-specific survivalwas worse for AA in stage III (36% vs 81%,P<.001) and stage IV (30% vs 49%,P= .007).CONCLUSIONDespite presenting with more indolent histology and lower stage, African-Americans were atgreater risk for diminished survival, faring worse in overall survival for all stages and cancer-spe-cific survival in for stage III/IV RCC. Further investigation into factors associated with these dis-parities is warranted. UROLOGY 163: 164-176, 2022. (c) 2021 Elsevier Inc.

Automated summary

This study investigated the association between African-American race and survival in patients with Renal Cell Carcinoma (RCC). The results showed that despite having more indolent histology and lower stage, African-Americans had a greater risk of diminished survival. They had worse overall survival for all stages and worse cancer-specific survival for stage III/IV RCC.