title: Sociodemographic disparities in treatment and survival of small localized renal cell carcinoma: surgical resection versus thermal ablation.
abstract: To investigate national practice trends in the use of surgical resection (SX) versus thermal ablation (TA) for the management of T1aN0M0 renal cell carcinoma with regard to sociodemographic factors and associated outcomes.
  
  
  
  Patients diagnosed in 2004-2011 were identified using the Surveillance, Epidemiology and End Results registry. Sociodemographic factors predicting the use of surgery versus TA were determined using logistic regression. Cancer-specific survival was estimated using Kaplan-Meier method.
  
  
  
  Overall, 19,136 (92.9%) patients underwent SX versus 1468 (7.1%) TA. Patients who were unmarried, diagnosed between 2008 and 2011, Caucasian, aged ≥70 years, insured, residing in Pacific Coast and Northern Plains, and in metropolitan areas with higher median family income had higher likelihoods of undergoing TA. Age-adjusted cancer-specific survival was similar in the two groups.
  
  
  
  Despite similar survival outcomes between SX versus TA, management of T1a renal cell carcinoma lesions may be influenced by a variety of nonclinical sociodemographic factors.
authors.affiliation: Department of Radiology & Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Nima
authors.initials: N
authors.lastname: Kokabi
authors.affiliation: Division of Interventional Radiology, Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Minzhi
authors.initials: M
authors.lastname: Xing
authors.affiliation: Department of Radiology & Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Duszak
authors.affiliation: Department of Health Policy & Management, Rollins School of Public Health, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Howard
authors.affiliation: Department of Radiology & Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Camacho
authors.affiliation: Division of Interventional Radiology, Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.|Yale Cancer Center, Yale University, New Haven, CT, USA.
authors.forename: Hyun S
authors.initials: HS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D018426:SEER Program; D016019:Survival Analysis
keywords: RCC; T1a; ablation; comparative effectiveness; nephrectomy; surgical resection