1261 UNDERTREATMENT OF PT1A RENAL LESIONS IN AFRICAN AMERICAN PATIENTS WITH NEPHRON-SPARING SURGERY

Abstract

You have accessJournal of UrologyKidney Cancer: Localized1 Apr 20111261 UNDERTREATMENT OF PT1A RENAL LESIONS IN AFRICAN AMERICAN PATIENTS WITH NEPHRON-SPARING SURGERY Adam Rensing, Timur Roytman, Robert Figenshau, Brian Benway, Adam Kibel, Arnold Bullock, Robert Grubb, and Sam Bhayani Adam RensingAdam Rensing St. Louis, MO More articles by this author , Timur RoytmanTimur Roytman St. Louis, MO More articles by this author , Robert FigenshauRobert Figenshau St. Louis, MO More articles by this author , Brian BenwayBrian Benway St. Louis, MO More articles by this author , Adam KibelAdam Kibel St. Louis, MO More articles by this author , Arnold BullockArnold Bullock St. Louis, MO More articles by this author , Robert GrubbRobert Grubb St. Louis, MO More articles by this author , and Sam BhayaniSam Bhayani St. Louis, MO More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.946AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Nephron-sparing surgery (NSS) has been demonstrated to provide improved functional and equivalent oncologic outcomes as compared to radical extirpative surgery. However, limited data exists regarding the prevalence of NSS in African American (AA) patients with pT1a renal lesions as compared to their Caucasian counterparts. We therefore aim to evaluate the prevalence of NSS in AA patients with pT1a renal lesions. METHODS A retrospective chart review was performed, evaluating the records of patients treated at a tertiary referral center between July 2008 and April 2010. Patients with renal lesions < or equal to 4 cm were included in the study. Patients with ESRD, metastatic disease and medical renal disease were excluded. 260 patients were identified: 30 patients were African American and 230 were Caucasian. Results were analyzed using two-tailed T test. RESULTS The AA cohort consisted of 30 patients with mean age of 57, mean lesion size of 2.58, mean pre-operative GFR of 73 and mean BMI of 33. The Caucasian cohort consisted of 230 patients with mean age of 59, mean lesion size of 2.40, mean pre-operative GFR of 76 and mean BMI of 31. Differences between the two cohorts in pre-operative GFR and BMI where statistically significant with p < 0.05. In the AA cohort, 6 patients (20%) underwent radical nephrectomy and 24 patients (80%) underwent NSS. In the Caucasian cohort, 26 patients (11%) underwent radical nephrectomy and 204 patients underwent NSS. The difference in the prevalence of NSS between AA and Caucasian cohort was statistically significant with p < 0.05. The mean post-operative GFR in the AA cohort was 46 and in the Caucasian cohort it was 62 which was statistically significant, p < 0.05. Predominant histology in each group was clear cell renal cell carcinoma. CONCLUSIONS Our data indicates that for pT1a renal lesions, African American patients are almost twice as likely as Caucasian patients to undergo radical nephrectomy. Functional outcomes, as evidenced by the post-operative GFR, are statistically worse in the AA patients than in Caucasian patients. Further studies are necessary to investigate the disparity in the prevalence of NSS in African American patients with pT1a lesions. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e504 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adam Rensing St. Louis, MO More articles by this author Timur Roytman St. Louis, MO More articles by this author Robert Figenshau St. Louis, MO More articles by this author Brian Benway St. Louis, MO More articles by this author Adam Kibel St. Louis, MO More articles by this author Arnold Bullock St. Louis, MO More articles by this author Robert Grubb St. Louis, MO More articles by this author Sam Bhayani St. Louis, MO More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...