1. Survival Outcomes by Race Following Surgical Treatment for Upper Tract Urothelial Carcinoma.
- Author
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Zappia J, Yong C, Slaven J, Wu Z, Wang L, Djaladat H, Wood E, Ghoreifi A, Abdollah F, Davis M, Stephens A, Simone G, Tuderti G, Gonzalgo ML, Mendiola DF, Derweesh IH, Dhanji S, Hakimi K, Margulis V, Taylor J, Ferro M, Tozzi M, Autorino R, Pandolfo SD, Mehrazin R, Eilender B, Porpiglia F, Checcucci E, and Sundaram CP
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Asia epidemiology, Europe epidemiology, Racial Groups statistics & numerical data, Retrospective Studies, United States epidemiology, Ureteral Neoplasms ethnology, Ureteral Neoplasms mortality, Ureteral Neoplasms surgery, Urologic Neoplasms ethnology, Urologic Neoplasms mortality, Urologic Neoplasms surgery, Carcinoma, Transitional Cell ethnology, Carcinoma, Transitional Cell mortality, Carcinoma, Transitional Cell surgery, Nephroureterectomy methods
- Abstract
Objective: Discrepancies in survival outcomes of various genitourinary tract malignancies have been documented across different racial and ethnic groups. Here we sought to examine long-term survival outcomes of patients with upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU) when stratified by race., Methods: A multicenter retrospective analysis using the ROBUUST (ROBotic surgery for Upper tract Urothelial cancer Study) registry identified patients undergoing RNU for UTUC between 2015 and 2022 at 12 centers across the United States, Europe, and Asia. Patients were stratified by race (white, black, Hispanic, and Asian) and primary outcomes of interest-including recurrence-free survival (RFS), metastasis free survival (MFS) and overall survival (OS) - were assessed using univariate analysis, multivariate Cox regression modeling, and Kaplan-Meier analysis., Results: 1446 patients (white n = 652, black n = 70, Hispanic n = 87, and Asian n = 637) who underwent RNU for treatment of the UTUC were included in our analysis. Cox regression modeling demonstrated pathologic nodal staging to be a significant predictor of RFS (HR 2.25; P = .0010), MFS (HR 2.50; P = .0028), and OS (HR 5.11; P < .0001). When using whites as the reference group, there were no significant differences in RFS, MFS, or OS across racial groups., Conclusions: Unlike other genitourinary tract malignancies, our study failed to demonstrate a survival disadvantage among minority racial groups with UTUC who underwent RNU. Furthermore, a significant difference in RFS, MFS, and OS was not identified across whites, blacks, Asians, or Hispanics with UTUC who underwent RNU., Competing Interests: Disclosure The authors have stated that they have no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Published
- 2024
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