Racial disparity in outcomes of a clinical trial population with metastatic renal cell carcinoma.

Abstract:

OBJECTIVES:Population studies have revealed that black Americans with renal cell carcinoma (RCC) have a shorter survival than do white Americans. Differences in socioeconomic status and treatment are frequently cited as the reasons for this disparity. The effect of these social obstacles may be reduced by studying a patient population with advanced RCC enrolled in clinical trials, because patients in these trials are likely to be similar in terms of their access to care, compliance, and performance status. METHODS:A retrospective review of all patients with metastatic RCC enrolled in clinical trials at Wayne State University from 1992 to 2002 was conducted. Log-rank survival analysis by age, sex, race, smoking history, nephrectomy history, prior therapy, type of protocol therapy (immunotherapy versus other), performance status (0 versus 1 to 2), and number of metastatic sites was conducted. Univariate and multivariate comparisons by race were performed for overall survival and time to progression. RESULTS:A total of 122 patients (median age 57 years) were enrolled; 21 (17%) were black and 101 (83%) were white. Overall survival was significantly shorter for the black Americans (P = 0.0027). The median survival for black Americans and white Americans was 6.9 and 11.5 months, respectively. On multivariate analysis, black race and performance status of 0 versus 1 and 2 were significant predictors of shorter survival. The presence of liver metastases and/or the absence of prior nephrectomy also influenced the length of overall survival through an interaction effect. CONCLUSIONS:Within a clinical trial patient population with RCC, race was a significant predictor of overall survival.

journal_name

Urology

journal_title

Urology

authors

Tripathi RT,Heilbrun LK,Jain V,Vaishampayan UN

doi

10.1016/j.urology.2006.02.036

subject

Has Abstract

pub_date

2006-08-01 00:00:00

pages

296-301

issue

2

eissn

0090-4295

issn

1527-9995

pii

S0090-4295(06)00271-8

journal_volume

68

pub_type

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