title: Racial Disparities in Histology and Short-Term Renal Functional Outcomes Following Robotic Nephron-Sparing Surgery.
abstract: To identify variations in renal function and histology between Caucasian Americans (CA) and African Americans (AA) undergoing robotic nephron-sparing surgery (NSS).
  
  
  
  A retrospective chart review was performed on patients who underwent NSS. Multivariate analysis identified factors affecting postoperative estimated glomerular filtration rate (eGFR). Histology was re-reviewed by pathology to confirm papillary type.
  
  
  
  A total of 331 patients underwent NSS: CA (n = 212), AA (n = 105), Hispanic (n = 10), and other (n = 4). AA average age (60.1 years) was lower than CA (62.3 years) (P < .001), with a higher proportion of AA women (46%) than CA (37%) (P = .021). AA had a higher incidence of diabetes (58.2%) and hypertension (93.9%). Preoperative average eGFR was similar: 70.35 mL/min for AA versus 69.06 mL/min for CA. Average postoperative eGFR was 50.59 mL/min for AA and 57.85 mL/min for CA. Postoperative creatinine increased more in AA (0.44 mg/dL) versus CA (0.33 mg/dL) (P < .001) even when stratified by pathological stage. Clear cell renal cell carcinoma (RCC) was the most common histology with AA (45%) and CA (60%). A greater than 2-fold higher incidence of papillary RCC was observed in AA (31%) versus CA (13%). AA exhibited a greater proportion of high-grade or type 2 papillary RCC (40% and 30%) versus CA (25% and 13%).
  
  
  
  AA patients were treated at a younger age, with a larger proportion of women. Postoperatively, AA experienced a greater increase in serum creatinine. Final histology demonstrated greater papillary RCC incidence in AA and increased likelihood for type 2 papillary RCC, a more aggressive histology.
authors.affiliation: Department of Urology, Tulane University School of Medicine, New Orleans, LA.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Wang
authors.affiliation: Department of Urology, Tulane University School of Medicine, New Orleans, LA.
authors.forename: Weil R
authors.initials: WR
authors.lastname: Lai
authors.affiliation: Department of Urology, Tulane University School of Medicine, New Orleans, LA.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Traore
authors.affiliation: Department of Urology, Tulane University School of Medicine, New Orleans, LA.
authors.forename: James
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Pathology, Tulane University School of Medicine, New Orleans, LA.
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Sholl
authors.affiliation: Department of Urology, Tulane University School of Medicine, New Orleans, LA.
authors.forename: Sree Harsha
authors.initials: SH
authors.lastname: Mandava
authors.affiliation: Department of Urology, Tulane University School of Medicine, New Orleans, LA.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Maddox
authors.affiliation: Department of Urology, Tulane University School of Medicine, New Orleans, LA.
authors.forename: Gregory C
authors.initials: GC
authors.lastname: Mitchell
authors.affiliation: Department of Urology, Tulane University School of Medicine, New Orleans, LA.
authors.forename: Sarayuth
authors.initials: S
authors.lastname: Viriyasiripong
authors.affiliation: Department of Urology, Tulane University School of Medicine, New Orleans, LA.
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Silberstein
authors.affiliation: Division of Urology, University of Arizona College of Medicine, Tucson, AZ.
authors.forename: Rick
authors.initials: R
authors.lastname: Kittles
authors.affiliation: Division of Urology, University of Arizona College of Medicine, Tucson, AZ. Electronic address: brlee@surgery.arizona.edu.
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000208:ethnology / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000503:physiopathology*; D007680:Kidney Neoplasms / Q000208:ethnology / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000379:methods*; D044465:White People; D055815:Young Adult
keywords: Nephron sparing surgery; Papillary; Pathology; Renal cell carcinoma; Robotic Partial Nephrectomy