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The effect of race on stage at presentation and survival in upper tract urothelial carcinoma

C. Collà Ruvolo, M. Wenzel, L. Nocera, C. Würnschimmel, Z. Tian, SF. Shariat, F. Saad, N. Longo, C. Imbimbo, A. Briganti, V. Mirone, PI. Karakiewicz

. 2021 ; 39 (11) : 788.e7-788.e13. [pub] 20210727

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc22012049

Background The effect of racial/ethnic group on survival in upper tract urothelial carcinoma (UTUC) is unknown. We tested this concept in non-metastatic UTUC patients treated with radical nephroureterectomy (RNU) and hypothesized that important differences may exist according to racial/ethnic groups. Material and Methods We relied on the Surveillance Epidemiology and End Results database (2004-2016). We relied on Propensity-score matching (ratio 1:4). Subsequently, cumulative incidence plots and multivariable competing risks regression models (CRR) addressed cancer-specific mortality (CSM). Results Of 9129 assessable patients, 7454 (81.7%) were Caucasian vs. 665 (7.3%) Hispanic vs. 584 (6.4%) Asian vs. 426 (4.7%) African-American. No statistically significant differences were recorded for tumor grade or T-stage, between all racial/ethnic groups. However, within patents who received lymph-node dissection (n = 2694, 29.5%), Asians exhibited the highest rate of more than 2 positive lymph nodes at RNU (19.0%, followed by 17.1% African-Americans, 15.0% Caucasians and 12.6% Hispanics, P < 0.001). After PS-matching and multivariable CRR, Asian race/ethnicity independently predicted higher CSM, relative to Caucasians (Hazard ratio: 1.29, P < 0.01). No statistically significant differences according to CSM was recorded in the remaining races/ethnicities comparisons (all P ≥ 0.1) Conclusion Important CSM differences may exist according to race/ethnicity in non-metastatic UTUC patients treated with RNU. However, these differences only apply to Asian patients, who account for 6% of the overall non-metastatic UTUC cohort treated with RNU. In consequence, in clinical practice Asian patients should be given particular attention with the intent of reducing the CSM disadvantage that cannot be clearly explained by stage and/or grade disadvantage at diagnosis.

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$a Background The effect of racial/ethnic group on survival in upper tract urothelial carcinoma (UTUC) is unknown. We tested this concept in non-metastatic UTUC patients treated with radical nephroureterectomy (RNU) and hypothesized that important differences may exist according to racial/ethnic groups. Material and Methods We relied on the Surveillance Epidemiology and End Results database (2004-2016). We relied on Propensity-score matching (ratio 1:4). Subsequently, cumulative incidence plots and multivariable competing risks regression models (CRR) addressed cancer-specific mortality (CSM). Results Of 9129 assessable patients, 7454 (81.7%) were Caucasian vs. 665 (7.3%) Hispanic vs. 584 (6.4%) Asian vs. 426 (4.7%) African-American. No statistically significant differences were recorded for tumor grade or T-stage, between all racial/ethnic groups. However, within patents who received lymph-node dissection (n = 2694, 29.5%), Asians exhibited the highest rate of more than 2 positive lymph nodes at RNU (19.0%, followed by 17.1% African-Americans, 15.0% Caucasians and 12.6% Hispanics, P < 0.001). After PS-matching and multivariable CRR, Asian race/ethnicity independently predicted higher CSM, relative to Caucasians (Hazard ratio: 1.29, P < 0.01). No statistically significant differences according to CSM was recorded in the remaining races/ethnicities comparisons (all P ≥ 0.1) Conclusion Important CSM differences may exist according to race/ethnicity in non-metastatic UTUC patients treated with RNU. However, these differences only apply to Asian patients, who account for 6% of the overall non-metastatic UTUC cohort treated with RNU. In consequence, in clinical practice Asian patients should be given particular attention with the intent of reducing the CSM disadvantage that cannot be clearly explained by stage and/or grade disadvantage at diagnosis.
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$a Wenzel, Mike $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, University Hospital Frankfurt, Frankfurt, Germany
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$a Nocera, Luigi $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IBCAS San Raffaele Scientific Institute, Milan, Italy
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$a Würnschimmel, Christoph $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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$a Tian, Zhe $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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$a Shariat, Shahrokh F $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Departments of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern, Dallas, TX; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
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$a Saad, Fred $u Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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$a Longo, Nicola $u Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
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$a Imbimbo, Ciro $u Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
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$a Briganti, Alberto $u Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IBCAS San Raffaele Scientific Institute, Milan, Italy
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$a Mirone, Vincenzo $u Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples Federico II, Naples, Italy
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