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Published in: Journal of Robotic Surgery 1/2016

01-03-2016 | Original Article

Race effects on pathological and functional outcomes after robotic partial nephrectomy in a single academic tertiary care center

Authors: Onder Kara, Hiury S. Andrade, Homayoun Zargar, Oktay Akca, Matthew J. Maurice, Peter A. Caputo, Daniel Ramirez, Ercan Malkoc, Charles S. Modlin, Jihad H. Kaouk

Published in: Journal of Robotic Surgery | Issue 1/2016

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Abstract

To explore the potential effects of race on pathological outcomes of renal tumor and on kidney function preservation in the patients undergoing robotic partial nephrectomy (RPN) at our center. Retrospective review of our institutional review board approved database for African-American (AA) patients undergoing RPN from 2006 to 2014 was performed. AA and non-AA groups were compared with regards to demographics, tumor characteristics, functional data and, oncological outcomes. For functional outcomes, groups were matched (1:1) in terms of age, preoperative estimated glomerular filtration rate (eGFR) and R.E.N.A.L score. From the total of 1005 patients, 84 were AA. Age and the tumor size were comparable between the two groups (2.7 vs. 3 cm; p = 0.29). Proportion of patients with papillary RCC was higher among AAs compared to non-AAs (43.3 vs. 19.4 %; p < 0.001). After matching AA patients with non-AA counterparts (1:1 matching), eGFR preservation at latest follow up after surgery was comparable between groups (84.3 vs. 85 %; p = 0.25). AA race (OR 3.62, p < 0.001), male gender (OR 2.05, p < 0.001) and low preoperative eGFR (OR 0.97, p < 0.001) were predictors of papillary RCC on multivariate analyses. The incidence of papillary RCC is higher in AA patients undergoing RPN. There was no difference in kidney function recovery after robotic partial nephrectomy in both AA and non-AA groups. AA race itself is not a significant factor in determining renal malignancy. Further studies are needed to clarify the impact of higher prevalence of papillary tumors in AA group in terms of long-term oncological and functional outcomes.
Literature
1.
5.
go back to reference Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130(6):461–470CrossRefPubMed Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130(6):461–470CrossRefPubMed
6.
go back to reference Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, Hogg RJ, Perrone RD, Lau J, Eknoyan G, National Kidney F (2003) National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 139(2):137–147CrossRefPubMed Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, Hogg RJ, Perrone RD, Lau J, Eknoyan G, National Kidney F (2003) National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 139(2):137–147CrossRefPubMed
7.
go back to reference Eble JN SG, Epstein JI, Sesterhen IA (2004) World Health Organization classification of tumours. Pathology and genetics of tumours of the urinary system and male genital organs, vol 6. Lyon: IARC Press Eble JN SG, Epstein JI, Sesterhen IA (2004) World Health Organization classification of tumours. Pathology and genetics of tumours of the urinary system and male genital organs, vol 6. Lyon: IARC Press
9.
go back to reference Chow WH, Devesa SS, Warren JL, Fraumeni JF Jr (1999) Rising incidence of renal cell cancer in the United States. JAMA 281(17):1628–1631CrossRefPubMed Chow WH, Devesa SS, Warren JL, Fraumeni JF Jr (1999) Rising incidence of renal cell cancer in the United States. JAMA 281(17):1628–1631CrossRefPubMed
10.
go back to reference Berndt SI, Carter HB, Schoenberg MP, Newschaffer CJ (2007) Disparities in treatment and outcome for renal cell cancer among older black and white patients. J Clin Oncol Off J Am Soc Clin Oncol 25(24):3589–3595. doi:10.1200/JCO.2006.10.0156 CrossRef Berndt SI, Carter HB, Schoenberg MP, Newschaffer CJ (2007) Disparities in treatment and outcome for renal cell cancer among older black and white patients. J Clin Oncol Off J Am Soc Clin Oncol 25(24):3589–3595. doi:10.​1200/​JCO.​2006.​10.​0156 CrossRef
11.
go back to reference Modlin CS (2003) Culture, race, and disparities in health care. Cleve Clin J Med 70 (4):283, 287–288 Modlin CS (2003) Culture, race, and disparities in health care. Cleve Clin J Med 70 (4):283, 287–288
15.
go back to reference Akdogan B, Gudeloglu A, Inci K, Gunay LM, Koni A, Ozen H (2012) Prevalence and predictors of benign lesions in renal masses smaller than 7 cm presumed to be renal cell carcinoma. Clin Genitourinary Cancer 10(2):121–125. doi:10.1016/j.clgc.2012.01.005 CrossRef Akdogan B, Gudeloglu A, Inci K, Gunay LM, Koni A, Ozen H (2012) Prevalence and predictors of benign lesions in renal masses smaller than 7 cm presumed to be renal cell carcinoma. Clin Genitourinary Cancer 10(2):121–125. doi:10.​1016/​j.​clgc.​2012.​01.​005 CrossRef
16.
go back to reference Lee WK, Byun SS, Kim HH, Rha KH, Hwang TK, Sung GT, Lee W, Lim JS, Jeong YB, Kwon TG (2010) Characteristics and prognosis of chromophobe non-metastatic renal cell carcinoma: a multicenter study. Int J Urol Off J Jpn Urol Assoc 17(11):898–904. doi:10.1111/j.1442-2042.2010.02630.x Lee WK, Byun SS, Kim HH, Rha KH, Hwang TK, Sung GT, Lee W, Lim JS, Jeong YB, Kwon TG (2010) Characteristics and prognosis of chromophobe non-metastatic renal cell carcinoma: a multicenter study. Int J Urol Off J Jpn Urol Assoc 17(11):898–904. doi:10.​1111/​j.​1442-2042.​2010.​02630.​x
17.
go back to reference Patard JJ, Leray E, Rioux-Leclercq N, Cindolo L, Ficarra V, Zisman A, De La Taille A, Tostain J, Artibani W, Abbou CC, Lobel B, Guille F, Chopin DK, Mulders PF, Wood CG, Swanson DA, Figlin RA, Belldegrun AS, Pantuck AJ (2005) Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. J Clin Oncol Off J Am Soc Clin Oncol 23(12):2763–2771. doi:10.1200/JCO.2005.07.055 CrossRef Patard JJ, Leray E, Rioux-Leclercq N, Cindolo L, Ficarra V, Zisman A, De La Taille A, Tostain J, Artibani W, Abbou CC, Lobel B, Guille F, Chopin DK, Mulders PF, Wood CG, Swanson DA, Figlin RA, Belldegrun AS, Pantuck AJ (2005) Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. J Clin Oncol Off J Am Soc Clin Oncol 23(12):2763–2771. doi:10.​1200/​JCO.​2005.​07.​055 CrossRef
18.
go back to reference Capitanio U, Cloutier V, Zini L, Isbarn H, Jeldres C, Shariat SF, Perrotte P, Antebi E, Patard JJ, Montorsi F, Karakiewicz PI (2009) A critical assessment of the prognostic value of clear cell, papillary and chromophobe histological subtypes in renal cell carcinoma: a population-based study. BJU Int 103(11):1496–1500. doi:10.1111/j.1464-410X.2008.08259.x CrossRefPubMed Capitanio U, Cloutier V, Zini L, Isbarn H, Jeldres C, Shariat SF, Perrotte P, Antebi E, Patard JJ, Montorsi F, Karakiewicz PI (2009) A critical assessment of the prognostic value of clear cell, papillary and chromophobe histological subtypes in renal cell carcinoma: a population-based study. BJU Int 103(11):1496–1500. doi:10.​1111/​j.​1464-410X.​2008.​08259.​x CrossRefPubMed
20.
go back to reference Reuter VE, Presti JC Jr (2000) Contemporary approach to the classification of renal epithelial tumors. Semin Oncol 27(2):124–137PubMed Reuter VE, Presti JC Jr (2000) Contemporary approach to the classification of renal epithelial tumors. Semin Oncol 27(2):124–137PubMed
21.
go back to reference Sankin A, Cohen J, Wang H, Macchia RJ, Karanikolas N (2011) Rate of renal cell carcinoma subtypes in different races. Int Braz J Urol Off J Braz Soc Urol 37(1):29–32 (discussion 33–24) CrossRef Sankin A, Cohen J, Wang H, Macchia RJ, Karanikolas N (2011) Rate of renal cell carcinoma subtypes in different races. Int Braz J Urol Off J Braz Soc Urol 37(1):29–32 (discussion 33–24) CrossRef
23.
go back to reference Lipworth L, Morgans AK, Edwards TL, Barocas DA, Chang SS, Herrell SD, Penson DF, Resnick MJ, Smith JA, Clark PE (2014) Renal cell cancer histological subtype distribution differs by race and sex. BJU Int. doi:10.1111/bju.12950 (Epub ahead of print) Lipworth L, Morgans AK, Edwards TL, Barocas DA, Chang SS, Herrell SD, Penson DF, Resnick MJ, Smith JA, Clark PE (2014) Renal cell cancer histological subtype distribution differs by race and sex. BJU Int. doi:10.​1111/​bju.​12950 (Epub ahead of print)
26.
go back to reference Schmidt LS, Nickerson ML, Angeloni D, Glenn GM, Walther MM, Albert PS, Warren MB, Choyke PL, Torres-Cabala CA, Merino MJ, Brunet J, Berez V, Borras J, Sesia G, Middelton L, Phillips JL, Stolle C, Zbar B, Pautler SE, Linehan WM (2004) Early onset hereditary papillary renal carcinoma: germline missense mutations in the tyrosine kinase domain of the met proto-oncogene. J Urol 172(4 Pt 1):1256–1261CrossRefPubMed Schmidt LS, Nickerson ML, Angeloni D, Glenn GM, Walther MM, Albert PS, Warren MB, Choyke PL, Torres-Cabala CA, Merino MJ, Brunet J, Berez V, Borras J, Sesia G, Middelton L, Phillips JL, Stolle C, Zbar B, Pautler SE, Linehan WM (2004) Early onset hereditary papillary renal carcinoma: germline missense mutations in the tyrosine kinase domain of the met proto-oncogene. J Urol 172(4 Pt 1):1256–1261CrossRefPubMed
27.
go back to reference Toro JR, Nickerson ML, Wei MH, Warren MB, Glenn GM, Turner ML, Stewart L, Duray P, Tourre O, Sharma N, Choyke P, Stratton P, Merino M, Walther MM, Linehan WM, Schmidt LS, Zbar B (2003) Mutations in the fumarate hydratase gene cause hereditary leiomyomatosis and renal cell cancer in families in North America. Am J Hum Genet 73(1):95–106. doi:10.1086/376435 PubMedCentralCrossRefPubMed Toro JR, Nickerson ML, Wei MH, Warren MB, Glenn GM, Turner ML, Stewart L, Duray P, Tourre O, Sharma N, Choyke P, Stratton P, Merino M, Walther MM, Linehan WM, Schmidt LS, Zbar B (2003) Mutations in the fumarate hydratase gene cause hereditary leiomyomatosis and renal cell cancer in families in North America. Am J Hum Genet 73(1):95–106. doi:10.​1086/​376435 PubMedCentralCrossRefPubMed
28.
go back to reference Stewart JH, Buccianti G, Agodoa L, Gellert R, McCredie MR, Lowenfels AB, Disney AP, Wolfe RA, Boyle P, Maisonneuve P (2003) Cancers of the kidney and urinary tract in patients on dialysis for end-stage renal disease: analysis of data from the United States, Europe, and Australia and New Zealand. J Am Soc Nephrol JASN 14(1):197–207CrossRefPubMed Stewart JH, Buccianti G, Agodoa L, Gellert R, McCredie MR, Lowenfels AB, Disney AP, Wolfe RA, Boyle P, Maisonneuve P (2003) Cancers of the kidney and urinary tract in patients on dialysis for end-stage renal disease: analysis of data from the United States, Europe, and Australia and New Zealand. J Am Soc Nephrol JASN 14(1):197–207CrossRefPubMed
30.
go back to reference Woldu SL, Weinberg AC, RoyChoudhury A, Chase H, Kalloo SD, McKiernan JM, DeCastro GJ (2014) Renal insufficiency is associated with an increased risk of papillary renal cell carcinoma histology. Int Urol Nephrol 46(11):2127–2132. doi:10.1007/s11255-014-0780-4 CrossRefPubMed Woldu SL, Weinberg AC, RoyChoudhury A, Chase H, Kalloo SD, McKiernan JM, DeCastro GJ (2014) Renal insufficiency is associated with an increased risk of papillary renal cell carcinoma histology. Int Urol Nephrol 46(11):2127–2132. doi:10.​1007/​s11255-014-0780-4 CrossRefPubMed
31.
go back to reference Purdue MP, Moore LE, Merino MJ, Boffetta P, Colt JS, Schwartz KL, Bencko V, Davis FG, Graubard BI, Janout V, Ruterbusch JJ, Beebe-Dimmer J, Cote ML, Shuch B, Mates D, Hofmann JN, Foretova L, Rothman N, Szeszenia-Dabrowska N, Matveev V, Wacholder S, Zaridze D, Linehan WM, Brennan P, Chow WH (2013) An investigation of risk factors for renal cell carcinoma by histologic subtype in two case-control studies. Int J Cancer J Int Du Cancer 132(11):2640–2647. doi:10.1002/ijc.27934 CrossRef Purdue MP, Moore LE, Merino MJ, Boffetta P, Colt JS, Schwartz KL, Bencko V, Davis FG, Graubard BI, Janout V, Ruterbusch JJ, Beebe-Dimmer J, Cote ML, Shuch B, Mates D, Hofmann JN, Foretova L, Rothman N, Szeszenia-Dabrowska N, Matveev V, Wacholder S, Zaridze D, Linehan WM, Brennan P, Chow WH (2013) An investigation of risk factors for renal cell carcinoma by histologic subtype in two case-control studies. Int J Cancer J Int Du Cancer 132(11):2640–2647. doi:10.​1002/​ijc.​27934 CrossRef
Metadata
Title
Race effects on pathological and functional outcomes after robotic partial nephrectomy in a single academic tertiary care center
Authors
Onder Kara
Hiury S. Andrade
Homayoun Zargar
Oktay Akca
Matthew J. Maurice
Peter A. Caputo
Daniel Ramirez
Ercan Malkoc
Charles S. Modlin
Jihad H. Kaouk
Publication date
01-03-2016
Publisher
Springer London
Published in
Journal of Robotic Surgery / Issue 1/2016
Print ISSN: 1863-2483
Electronic ISSN: 1863-2491
DOI
https://doi.org/10.1007/s11701-016-0562-3

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