Effect of race/ethnicity on survival in surgically treated intermediate/high risk non‐metastatic clear cell renal carcinoma

Abstract

AbstractPurposeIt is unknown to what extent 10‐year overall survival of radical nephrectomy treated intermediate/high‐risk non‐metastatic clear cell renal carcinoma patients differs from age‐ and sex‐matched population‐based controls, especially when race/ethnicity is considered (Caucasian vs. African American vs. Hispanic vs. Asian/Pacific Islander).MethodsWe relied on the SEER database (2004–2018) to identify newly diagnosed radical nephrectomy treated intermediate/high risk non‐metastatic clear cell renal carcinoma patients. For each case, we simulated an age‐ and sex‐matched control relying on Social Security Administration Life Tables with 10 years of follow‐up. We compared overall survival between renal carcinoma cases and population‐based controls. Multivariable competing risks regression models tested for predictors of cancer‐specific mortality versus other‐cause mortality.ResultsOf 6877 radical nephrectomy treated intermediate/high risk non‐metastatic clear cell renal carcinoma patients, 5050 (73%) were Caucasian versus 433 (6%) African American versus 1002 (15%) Hispanic versus 392 (6%) Asian/Pacific Islanders. At 10 years, overall survival difference between radical nephrectomy treated intermediate/high risk non‐metastatic clear cell renal carcinoma patients versus population‐based controls was greatest in African Americans (51% vs. 81%, Δ = 30%), followed by Hispanics (54% vs. 80%, Δ = 26%), Asian/Pacific Islanders (56% vs. 80%, Δ = 24%) and Caucasians (52% vs. 74%, Δ = 22%). In competing risks regression, only African Americans exhibited significantly higher other cause mortality (hazard ratio = 1.3; 95% confidence interval = 1.1 – 1.6; p = 0.01) than others.ConclusionRelative to Life Tables' derived sex‐ and age‐matched controls, radical nephrectomy treated intermediate/high‐risk non‐metastatic clear cell renal carcinoma patients exhibit worse overall survival, with worst overall survival recorded in African Americans of all race/ethnicity groups.