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.
Clinical genitourinary cancer. 2016 Jul 22 [Epub ahead of print]
Julie C Wang, Weil R Lai, Elizabeth J Traore, James Liu, Andrew B Sholl, Sree Harsha Mandava, Michael M Maddox, Gregory C Mitchell, Sarayuth Viriyasiripong, Jonathan L Silberstein, Rick Kittles, Benjamin R Lee
Department of Urology, Tulane University School of Medicine, New Orleans, LA., Department of Pathology, Tulane University School of Medicine, New Orleans, LA., Division of Urology, University of Arizona College of Medicine, Tucson, AZ., Division of Urology, University of Arizona College of Medicine, Tucson, AZ. Electronic address: .