Clinicopathological characteristics and outcomes of surgically excised renal masses in African Americans.
OBJECTIVE
In the present study, we report on the clinical and pathological characteristics of African American (AA) patients with surgically excised renal masses and assess the associations between race and oncological outcomes.


METHODS
We conducted a retrospective review of patients who underwent partial or radical nephrectomy for renal masses at our institution between 2000 and 2010. Patients were divided into 2 groups based on self-reported race: AA and non-AA. Patient demographics and disease characteristics, and overall, cancer-specific, recurrence-free, distant, and local recurrence-free survival for localized renal cell carcinoma (RCC) were compared between AA and non-AA patients. Multivariable proportional hazard analyses were used to assess the associations of race with oncological outcomes.


RESULTS
A total of 1,467 patients, of whom 359 (24.5%) were AA, were included. Rates of benign disease were comparable between AA patients and non-AA (18.2% vs. 17.6%, P = 0.556). AA patients presented with higher rates of localized disease (83% vs. 71%, P<0.001). Papillary subtype accounted for 40.8% of RCCs in AA patients compared with 11.6% in non-AA patients (P<0.001). The high proportion of papillary RCC in AA patients was maintained across disease stages. On univariable analyses, AA patients had better recurrence-free and cancer-specific survival. On multivariable analyses, AA race was not a significant predictor of oncological outcomes after adjusting for patient and disease characteristics.


CONCLUSIONS
In this study, AA patients presented with more localized disease than non-AA patients, whereas rates of benign disease were comparable between the groups. Furthermore, AA patients had roughly 3 times higher rates of papillary RCC across disease stages. On univariable analyses, AA patients appeared to have more favorable oncological outcomes. However, this association is likely explained by tumor stage, grade, and histology as outcomes were similar across races when the analyses were adjusted for these and other characteristics.
Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC.
Peter
P
Qi
Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC.
Matvey
M
Tsivian
Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC.
Michael R
MR
Abern
Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC.
Niccolo M
NM
Passoni
Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC.
Kathleen F
KF
McGinley
Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC. Electronic address: thomas.polascik@duke.edu.
Thomas J
TJ
Polascik
D001741:Black or African American; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000208:ethnology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000208:ethnology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009392:Nephrectomy / Q000379:methods*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States
African American; Oncological outcomes; Race; Renal cell carcinoma; Renal mass; Survival