Whether racial/ethnic differences exist in time to nephrectomy (TTN) and whether prolonged TTN differentially affects cancer-specific mortality (CSM) remains unclear. We evaluated race/ethnicity as a predictor of prolonged TTN and assessed race/ethnicity-specific associations between TTN and CSM in localized renal cell carcinoma (RCC).
Patients were identified within the Surveillance, Epidemiology and End Results database (2010-2021) and stratified according to race/ethnicity and TTN ≤ 3 vs. > 3 months. Multivariable logistic regression models, propensity score matching (PSM) and multivariable competing risks regression models were used.
In 11,058 T1b-2 N0 M0 clear-cell RCC patients, TTN > 3 months was recorded in 1168 (15.6%) of 7506 Caucasians, in 505 (23.6%) of 2138 Hispanics, in 180 (26.6%) of 676 African Americans, and in 118 (16.0%) of 738 Asians and Pacific Islanders (API). Hispanic (OR 1.80, p < 0.001) and African American (OR 2.10, p < 0.001) race/ethnicity independently predicted higher proportions of TTN > 3 months, compared to Caucasian. Over the study span, the proportion of patients with TTN > 3 months increased significantly in all four racial/ethnic groups (all p < 0.01). After PSM, TTN > 3 months was associated with higher CSM in Caucasians (sHR 1.57, p < 0.001) and in Hispanics (sHR 1.55, p = 0.046), but not in African Americans or APIs.
In localized RCC patients treated with nephrectomy, TTN > 3 months became more prevalent over time in all four examined racial/ethnic groups. In Hispanics and African Americans, TTN > 3 months proportions were higher than in Caucasians and APIs. TTN > 3 months was independently associated with higher CSM in Caucasians and Hispanics, but not in African Americans and APIs.
International urology and nephrology. 2026 Apr 16 [Epub ahead of print]
Maximilian Filzmayer, Federico Polverino, Michele Petix, Leonardo Quarta, Filippo Orlandi, Jordan A Goyal, Nicola Longo, Gennaro Musi, Alberto Briganti, Salvatore Micali, Shahrokh F Shariat, Marina Kosiba, Clara Humke, Mike Wenzel, Fred Saad, Felix K-H Chun, Pierre I Karakiewicz
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, 1000 Rue Saint-Denis, Montreal, H2X 0C1, Canada. ., Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, 1000 Rue Saint-Denis, Montreal, H2X 0C1, Canada., Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy., Università Degli Studi Di Milano, Milan, Italy., Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy., Department of Urology, AOU di Modena, University of Modena and Reggio Emilia, Modena, Italy., Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria., Department of Urology, Goethe University, University Hospital, Frankfurt am Main, Germany.