PD25-07 RACIAL DISPARITIES IN SURGICAL TREATMENT OF RENAL MASSES: INITIAL ANALYSIS OF A STATEWIDE REGISTRY

Abstract

You have accessJournal of UrologyCME1 May 2022PD25-07 RACIAL DISPARITIES IN SURGICAL TREATMENT OF RENAL MASSES: INITIAL ANALYSIS OF A STATEWIDE REGISTRY Mohit Butaney, Ji Qi, Stephanie Daignault-Newton, Randy Vince, Anna Johnson, Amit Patel, Susan Linsell, Simpa Salami, Firas Abdollah, Khurshid Ghani, Humphrey Atiemo, Brian Lane, Craig Rogers, and for the Michigan Urological Surgery Improvement Collaborative Mohit ButaneyMohit Butaney More articles by this author , Ji QiJi Qi More articles by this author , Stephanie Daignault-NewtonStephanie Daignault-Newton More articles by this author , Randy VinceRandy Vince More articles by this author , Anna JohnsonAnna Johnson More articles by this author , Amit PatelAmit Patel More articles by this author , Susan LinsellSusan Linsell More articles by this author , Simpa SalamiSimpa Salami More articles by this author , Firas AbdollahFiras Abdollah More articles by this author , Khurshid GhaniKhurshid Ghani More articles by this author , Humphrey AtiemoHumphrey Atiemo More articles by this author , Brian LaneBrian Lane More articles by this author , Craig RogersCraig Rogers More articles by this author , and for the Michigan Urological Surgery Improvement Collaborative More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002567.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Nephron-sparing approaches and surveillance are increasingly popular strategies to manage clinical T1 renal masses (cT1RM). It is well known that social and racial disparities affect access to healthcare resources and even oncological outcomes. Our objective in the project was to gain insight into potential racial disparities in initial management of cT1RM to guide our future quality improvement efforts. METHODS: The MUSIC-KIDNEY (Michigan Urological Surgery Improvement Collaborative—Kidney mass: Identifying and Defining Necessary Evaluation and Therapy) registry commenced data collection in June 2017. Data abstractors recorded clinical and follow-up data for patients with newly diagnosed cT1RMs at 16 MUSIC practices with >90 physicians. Practices with at least 5 White and 5 African-American (AA) patients were included in the analysis. Bivariate analysis and multivariable regression model were performed to assess association between race and treatment decision. RESULTS: Our cohort included 2932 patients including 2231 (76%) White, 433 (15%) AA, and 268 (9.1%) patients with other/unknown race. AA patients were more likely to be female, have public insurance, higher comorbidity when compared to white patients (p<0.05 for each). Overall, AA patients were more likely to undergo surveillance when compared to white patients (61% vs 51%, p<0.01) and less likely to undergo a partial nephrectomy (PN) (21% vs 31%, p<0.01); rates of RN and ablation/other were not statistically different (p>0.05) (Figure). We continued to observe a similar trend across practices despite the observed variation. Controlling for patient and tumor characteristics, AA were more likely to undergo surveillance compared to White patients (OR=1.55, p<0.01). CONCLUSIONS: Our data provide an initial assessment of the effect race may play in decision-making associated with management of cT1RM in a statewide registry. This is consistent with other publications showing disparities in initial management for small renal masses in which AA patients were less likely to receive PN; we add to these data by identifying an increased proportion receiving surveillance. These data will provide a benchmark as we further investigate potential disparities as one component of MUSIC’s quality improvement efforts. Source of Funding: Blue Cross Blue Shield of Michigan © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e423 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohit Butaney More articles by this author Ji Qi More articles by this author Stephanie Daignault-Newton More articles by this author Randy Vince More articles by this author Anna Johnson More articles by this author Amit Patel More articles by this author Susan Linsell More articles by this author Simpa Salami More articles by this author Firas Abdollah More articles by this author Khurshid Ghani More articles by this author Humphrey Atiemo More articles by this author Brian Lane More articles by this author Craig Rogers More articles by this author for the Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement PDF DownloadLoading ...