Survival Rates in Renal Cell Carcinoma Vary for African American Patients
African American race was associated with longer survival in non-clear cell metastatic renal cell carcinoma compared with Hispanic and Caucasian patients.
BY Conor Killmurray
PUBLISHED March 11, 2020
African American race was associated with prolonged survival in non-clear cell metastatic renal cell carcinoma, according to data published in Cancer Causes & Control.
However, African American race was also associated with lower survival rates in clear cell metastatic renal cell carcinoma.
Researchers looked at data from the Surveillance, Epidemiology, and End Results (SEER) registry to test the association between African American race with metastatic renal cell carcinoma (mRCC) as the association between race and survival in the disease is controversial. According to researchers, the effect of the patient’s race remains unclear on the survival rates but there is a survival disadvantage between Caucasian patients and African American patients in RCC.
Looking at the SEER data from 2006 to 2015 they identified African American, Hispanic and Caucasian patients with clear cell metastatic renal cell carcinoma (ccmRCC) and non-clear cell metastatic renal cell carcinoma (non-ccmRCC). The data was then stratified according to the histology and treatments of the patients into four different categories: No treatment, systematic therapy, cytoreductive nephrectomy and systematic therapy combined with cytoreductive nephrectomy.
This was done in order for the researchers to compare overall mortality rates, but also to see if there were exceptions to the way patients were treated. What they found was that the exception to their observations was the patients treated in combination with systematic therapy and cytoreductive nephrectomy for both ccmRCC and non-ccmRCC.
“Our analyses confirmed the association between African American race and higher mortality rates in ccmRCC patients, including the response to systemic therapy,” the researchers wrote. “Conversely, in non-ccmRCC, African Americans were associated with lower mortality rates, when compared to Caucasians and Hispanics, including the response to systemic therapies, CNT, or no treatment.”
Of the 473 deaths that the researchers observed, 318 were among Caucasian patients, 50 were among Hispanic patients and 105 were among African American patients. Median overall survival was 16, 11, and 10 months respectively. African American patients were associated with lower overall mortality rates than Caucasian patients.
From a total of 3,533 deaths among patients with ccmRCC, 2,684 occurred in the Caucasian population, 580 in the Hispanic population and 269 in the African American population.
However, African American patients with ccmRCC had a lower median overall survival compared with Caucasian patients and also had a higher overall mortality risk than Caucasian patients. Unmarried status, female gender and high-grade tumors were all associated with higher rates of overall mortality, except in patients with non-ccmRCC.
“Moreover, a larger proportion of African-Americans were diagnosed with mRCC in more recent years,” researchers concluded. “This finding was observed only in non-ccmRCC and is consistent with previous epidemiological reports, which suggested that the incidence rate of non-ccRCC has increased more rapidly in African- Americans than Caucasians.”