You have accessJournal of UrologyUrothelial Cancer: Upper Tract Tumors1 Apr 2011661 RACIAL/ETHNIC DIFFERENCES IN UPPER-TRACT UROTHELIAL CANCER GM Monawar Hosain, Myrna Khan, Gilad Amiel, Seth Lerner, David latini, and John Chen GM Monawar HosainGM Monawar Hosain Houston, TX More articles by this author , Myrna KhanMyrna Khan Houston, TX More articles by this author , Gilad AmielGilad Amiel Houston, TX More articles by this author , Seth LernerSeth Lerner Houston, TX More articles by this author , David latiniDavid latini Houston, TX More articles by this author , and John ChenJohn Chen Houston, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1591AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Racial/ethnic differences in demographics, cancer stage, treatment and outcome have been observed for many cancer sites. However, data on upper-tract urothelial carcinomas (UTUCs) involving the renal pelvis and ureter are scarce. This study attempted to examine clinical and demographic characteristics and survivals of persons with incident UTUC. METHODS We used a population-based Surveillance, Epidemiology, and End Results (SEER) database from 1988–2007 in the analysis. Race/ethnicity was classified as white, African American (AA) and Hispanics. The study subjects diagnosed with UTUCs were ascertained by ICD-9 codes. We compared racial/ethnic differences in UTUC by gender, age at diagnosis, tumor size, disease stage, lymph node-related data and survival. Chi-square and ANOVA were carried out for analysis of categorical and continuous variables, respectively. Disease-specific survival was calculated, using a Kaplan-Meier model and tested by log-rank test. Cox proportional-hazards models were used to adjust for the effects of various covariates on hazards of death. RESULTS We identified 17,074 UTUC cases in the SEER database from 1988–2007. AA patients were diagnosed at a younger age (67.9 yrs) than whites and Hispanics (71.8 yrs and 69.0 yrs, respectively; p=.004). Whites were less likely to be diagnosed with distant-stage disease (9.0%) compared to AAs and Hispanics (12.7% and 12.5%, respectively; p<.0001), whereas Hispanics were more likely to be diagnosed with larger tumor size (4.4 cm) compared to whites and AAs (3.6 cm and 3.8 cm, respectively). No racial/ethnic differences were observed either in lymph- node removal (17.9%, 17.8 and 17.0% from whites, AAs and Hispanics respectively; p=0.75), or in finding a positive node (4.9%, 4.9% and 5.4% in whites, AAs and Hispanics, respectively; p=0.80). A higher mean number of lymph nodes were examined in Hispanics (6.0) compared to whites (4.8) and AAs (5.3), and it was marginally significant (p=0.07). Cox proportional-hazard model revealed that Hispanics and AAs had a higher risk of dying (HR=1.26, 95% CI=1.12–1.43, p=.0002 and HR=1.10, 95% CI=0.93–1.27, p=.27, respectively) from UTUC than whites. CONCLUSIONS We observed racial/ethnic differences in UTUC cancer-stage distribution and survival as has been seen with other cancers. While no differences were observed for lymph node dissection/examination, we observed that only a small proportion of patients received lymph node dissection across all racial/ethnic groups. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e267 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information GM Monawar Hosain Houston, TX More articles by this author Myrna Khan Houston, TX More articles by this author Gilad Amiel Houston, TX More articles by this author Seth Lerner Houston, TX More articles by this author David latini Houston, TX More articles by this author John Chen Houston, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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