Racial Disparities in Histology and Short-Term Renal Functional Outcomes Following Robotic Nephron-Sparing Surgery
| Autor: | Sarayuth Viriyasiripong, Sree Harsha Mandava, Andrew B. Sholl, Rick A. Kittles, James Liu, Elizabeth J. Traore, Weil R. Lai, Julie C. Wang, Benjamin R. Lee, Michael Maddox, Jonathan L. Silberstein, Gregory C. Mitchell |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Urology 030232 urology & nephrology Renal function Kidney White People 03 medical and health sciences chemistry.chemical_compound Young Adult 0302 clinical medicine Robotic Surgical Procedures Renal cell carcinoma medicine Humans Young adult Carcinoma Renal Cell Aged Retrospective Studies Creatinine business.industry Incidence (epidemiology) Histology Retrospective cohort study Middle Aged medicine.disease Kidney Neoplasms Surgery Black or African American medicine.anatomical_structure Treatment Outcome Oncology chemistry 030220 oncology & carcinogenesis Urologic Surgical Procedures Female business Organ Sparing Treatments Glomerular Filtration Rate |
| Zdroj: | Clinical genitourinary cancer. 15(2) |
| ISSN: | 1938-0682 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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