Piccinelli Mattia Luca, Garcia Cristina Cano, Panunzio Andrea, Tappero Stefano, Barletta Francesco, Incesu Reha-Baris, Tian Zhe, Luzzago Stefano, Mistretta Francesco A, Ferro Matteo, Saad Fred, Shariat Shahrokh F, Graefen Markus, Briganti Alberto, Terrone Carlo, Antonelli Alessandro, Chun Felix K H, de Cobelli Ottavio, Musi Gennaro, Karakiewicz Pierre I
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.
Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.
J Surg Oncol. 2024 Dec;130(8):1683-1690. doi: 10.1002/jso.27795. Epub 2024 Aug 25.
It 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).
We 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.
Of 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.
Relative 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.
接受根治性肾切除术的中/高风险非转移性透明细胞肾细胞癌患者的10年总生存率与年龄和性别匹配的基于人群的对照组相比，差异程度尚不清楚，尤其是在考虑种族/族裔时（白种人、非裔美国人、西班牙裔、亚裔/太平洋岛民）。
我们依据监测、流行病学和最终结果（SEER）数据库（2004 - 2018年）来识别新诊断的接受根治性肾切除术的中/高风险非转移性透明细胞肾细胞癌患者。对于每例患者，我们依据社会保障管理局生命表模拟出年龄和性别匹配的对照组，并进行10年的随访。我们比较了肾癌患者与基于人群的对照组之间的总生存率。多变量竞争风险回归模型对癌症特异性死亡率与其他原因死亡率的预测因素进行了检验。
在6877例接受根治性肾切除术的中/高风险非转移性透明细胞肾细胞癌患者中，5050例（73%）为白种人，433例（6%）为非裔美国人，1002例（15%）为西班牙裔，392例（6%）为亚裔/太平洋岛民。10年时，接受根治性肾切除术的中/高风险非转移性透明细胞肾细胞癌患者与基于人群的对照组之间的总生存差异在非裔美国人中最大（51%对81%，差值 = 30%），其次是西班牙裔（54%对80%，差值 = 26%）、亚裔/太平洋岛民（56%对80%，差值 = 24%）和白种人（52%对74%，差值 = 22%）。在竞争风险回归中，只有非裔美国人表现出比其他种族显著更高的其他原因死亡率（风险比 = 1.3；95%置信区间 = 1.1 - 1.6；p = 0.01）。
相对于生命表得出的性别和年龄匹配的对照组，接受根治性肾切除术的中/高风险非转移性透明细胞肾细胞癌患者的总生存率更差，在所有种族/族裔群体中，非裔美国人的总生存率最差。
