Racial diversity among histology of renal cell carcinoma at an urban medical center.

Abstract

622 Background: Non-Hispanic Blacks (NHB) with renal cell carcinoma (RCC) are more likely to have papillary RCC (pRCC) than Non-Hispanic Whites (NHW). Little is known about the histology of RCC in Hispanics (H). The Montefiore-Einstein Cancer Center (MECC) serves a diverse population in the Bronx, NY. We sought to investigate histological subtype-specific associations with established RCC risk factors in an ethnically diverse patient population to elucidate prospective relationships between those factors and racial differences in RCC histology. Methods: : The MECC tumor registry was used to identify patients ≥18 years of age treated with partial or radical nephrectomy between January 2000 and December 2015. An institutional software program and individual chart review were used to obtain demographic data (including self-reported race, age, and sex), pathology data, and RCC risk factors (hypertension, diabetes, smoking status, renal function, weight). Data were modeled by multinomial logistic regression to estimate odds ratios (ORs) and 95% CIs. Results: 1010 RCC cases were identified (232 NHW, 383 NHB, 181 H, and 214 other). Histology was 530 clear cell (ccRCC), 257 papillary (pRCC), 100 chromophobe (cRCC), and 123 other. Individuals with pRCC compared to ccRCC were more likely to be NHB than NHW (OR 4.41; 95%CI 2.81,6.93) and more likely to have a higher Fuhrman grade (OR 1.5; 95%CI 1.03,2.07), but were less likely to be female (OR 0.50; 95%CI 0.35,0.72) or H than NHW (OR 0.518, 95%CI 0.271,0.991). Individuals with cRCC compared to ccRCC were also more likely to be NHB than NHW (OR 2.23, 95%CI 1.06,4.67) and to have higher Fuhrman grade (OR 1.82, 95%CI 1.06,3.14). Conclusions: In the MECC dataset, histology of RCC varies by race, confirming earlier reports that non-ccRCC is more common in NHB than NHW. We also report for the first time that pRCC is less common in H than NHW. These associations will be evaluated in additional larger national data sets and may help elucidate reasons for disparate RCC outcomes among various races and ethnicities.