For a study, researchers sought to assess the effects of ethnic, gender, and socioeconomic inequalities on survival when it comes to the treatment of metastatic renal cell carcinoma (mRCC).
Analysis was done on patients diagnosed with mRCC under the age of ≥18 in the National Cancer Database between 2004 and 2015. To assess the variables linked to the use of systemic treatment and cytoreductive nephrectomy (CN), multivariable logistic regression models were utilized. In addition, to assess overall survival, Cox proportional hazards regression models were applied.
A total of 31,989 patients with mRCC were found, of whom 30.2% received CN, 51.6% received systemic therapy, and 25.8% had no treatment at all. Females had higher odds of not receiving treatment (OR 1.14, P<.01) and lower odds of obtaining systemic therapy (OR 0.91, P<.01). Patients who were non-Hispanic Black or Hispanic had lower odds of obtaining CN (OR 0.75, P<.01, and OR 0.86, P=.01, respectively). Black patients had higher odds of not obtaining treatment (OR 1.41, P<.01) and lower odds of receiving systemic therapy (OR 0.85, P<.01). Black patients had a higher risk of mortality after adjusting for demographic and disease-related factors (HR 1.06, P=.03), mostly because they used CN and systemic treatment less frequently. However, survival disparities vanished after taking therapeutic usage into account (HR 0.99, P=.66).
Different approaches to treating mRCC were used depending on a patient’s race, gender, and socioeconomic status, and these approaches differ in terms of overall survival. Reducing inequities and increasing outcomes for mRCC may be achieved by removing structural obstacles and enhancing access to care.