Category Ranking

98%

Total Visits

921

Avg Visit Duration

2 minutes

Citations

20

Article Abstract

African American (AA) race has been identified to have a higher incidence of chronic kidney disease (CKD) and worse renal cancer survival compared with Caucasian Americans (CA), irrespective of tumor size, pathologic type, and surgical procedure. We aimed to compare the outcomes between CA and AA patients undergoing minimally invasive partial nephrectomy (PN) at our high-volume center. We queried our PN data repository from 2007 to 2017. We identified 981 cases of PN (robotic  = 943 and laparoscopic  = 38), of which there were 852 CA and 129 AA patients. We compared age, sex, body mass index (BMI), operative time, estimated blood loss (EBL), nephrometry score, tumor size, pre- and postoperative estimated glomerular filtration rate (eGFR), length of stay, Charlson Comorbidity Index (CCI), tumor characteristics, and 30-day complication rate. We then estimated the overall survival and disease-specific survival. Age, BMI, operative time, EBL, nephrometry score, tumor size, CCI, length of stay, and sex were not statistically different. The mean preoperative eGFR was higher in the AA cohort (91.4 mL/min/1.73 m 86.1 mL/min/1.73 m,  = 0.007); however, at 1 year, there was no mean difference (76.8 mL/min/1.73 m 74.5 mL/min/1.73 m,  = 0.428). There was a higher percentage of Fuhrman Grade 3/4 in the AA cohort (33.3% 22.5%,  = 0.044). The AA cohort had a 2.66 × higher incidence of papillary renal cell carcinoma (RCC) (34.9% 13.1%,  < 0.001) and unclassified RCC (3.9% 0.4%,  = 0.001). There was no difference in tumor stage ( = 0.260) or incidence of benign histology (15.3% 11.6%,  = 0.278). There were no differences in 30-day complications ( = 0.330). The median follow-up was 43.2 months. By using Kaplan-Meier curves, there was no observed difference in overall survival ( = 0.752) or disease-free survival ( = 0.403). Our cohort of AA and CA patients with intermediate follow-up showed no worse outcomes for CKD or survival when undergoing laparoscopic or robotic PN. For low-stage renal cancer, there was no difference in overall survival and disease-free survival at a median follow-up of 43.2 months among AA patients, despite having higher grade tumors and a higher percentage of unclassified RCC. Our cohort of AA patients did have a higher incidence of papillary RCC. The equivalent overall survival and disease-free survival could be due to the earlier discovery of lower stage renal masses incidentally identified on imaging studies performed equally for other reasons in both AA and CA patients.

Download full-text PDF

Source
http://dx.doi.org/10.1089/end.2020.0655DOI Listing

Publication Analysis

Top Keywords

tumor size
12
patients undergoing
8
undergoing minimally
8
minimally invasive
8
invasive partial
8
partial nephrectomy
8
bmi operative
8
operative time
8
ebl nephrometry
8
nephrometry score
8

Similar Publications

Objective: Thymic tumors are a rare group of anterior mediastinal tumors. Surgery is the primary treatment. Adjuvant treatment is used in select cases.

View Article and Find Full Text PDF

Purpose: Tarlatamab is a first-in-class, half-life extended bispecific T-cell engager (BiTE®) immunotherapy targeting delta-like ligand 3 (DLL3) currently approved for the treatment of adult patients with small cell lung cancer (SCLC) with disease progression on or after platinum-based chemotherapy. Here we report tarlatamab exposure-response relationships to inform dose selection in patients with SCLC.

Experimental Design: Pharmacokinetic data were correlated with therapeutic effect [exposure-response (ER) analyses] for efficacy and safety measures using pooled data from DeLLphi-300 and DeLLphi-301 studies.

View Article and Find Full Text PDF

Microscopic examination of biopsy tissues remains essential for cancer diagnosis, despite advancements in sequencing technologies. Alterations in nuclear size or the nuclear-to-cytoplasmic ratio are hallmark features of cancer cells and often correlate with disease progression. However, the mechanisms underlying nuclear size abnormalities and their impact on tumor progression remain unclear.

View Article and Find Full Text PDF

Importance: Janus kinase (JAK) inhibitors are highly effective medications for several immune-mediated inflammatory diseases (IMIDs). However, safety concerns have led to regulatory restrictions.

Objective: To compare the risk of adverse events with JAK inhibitors vs tumor necrosis factor (TNF) antagonists in patients with IMIDs in head-to-head comparative effectiveness studies.

View Article and Find Full Text PDF

Background: Postoperative late recurrence (POLAR) after 2 years from the date of surgical resection of hepatocellular carcinoma (HCC) represents a unique surveillance and management challenge. Despite identified risk factors, individualized prediction tools to guide personalized surveillance strategies for recurrence remain scarce. The current study sought to develop a predictive model for late recurrence among patients undergoing HCC resection.

View Article and Find Full Text PDF