Pd05-05 Health Inequalities for Renal Cell Carcinoma With Inferior Vena Cava Tumor Thrombus Across North America, Central/South America, and Asia

You have accessJournal of UrologyDiversity, Equity & Inclusion: Health Equity & Outcomes I (PD05)1 May 2024PD05-05 HEALTH INEQUALITIES FOR RENAL CELL CARCINOMA WITH INFERIOR VENA CAVA TUMOR THROMBUS ACROSS NORTH AMERICA, CENTRAL/SOUTH AMERICA, AND ASIA Maxwell Sandberg, Mary Namugosa, Rory Ritts, Davis Temple, Wyatt Whitman, Claudia Marie-Costa, Justin Refugia, Benjamin Eilender, Parth Thakker, Mitchell Hayes, Rafael Ribiero Zanotti, Patricio Garcia Marchiñena, Ashok Hemal, Reza Mehrazin, Philippe Spiess, Stenio de Cassio Zequi, and Alejandro Rodriguez Maxwell SandbergMaxwell Sandberg , Mary NamugosaMary Namugosa , Rory RittsRory Ritts , Davis TempleDavis Temple , Wyatt WhitmanWyatt Whitman , Claudia Marie-CostaClaudia Marie-Costa , Justin RefugiaJustin Refugia , Benjamin EilenderBenjamin Eilender , Parth ThakkerParth Thakker , Mitchell HayesMitchell Hayes , Rafael Ribiero ZanottiRafael Ribiero Zanotti , Patricio Garcia MarchiñenaPatricio Garcia Marchiñena , Ashok HemalAshok Hemal , Reza MehrazinReza Mehrazin , Philippe SpiessPhilippe Spiess , Stenio de Cassio ZequiStenio de Cassio Zequi , and Alejandro RodriguezAlejandro Rodriguez View All Author Informationhttps://doi.org/10.1097/01.JU.0001008624.07191.ab.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Renal cell carcinoma (RCC) with inferior vena cava (IVC) tumor thrombus is treated with nephrectomy and IVC thrombectomy. This carries a high morbidity and mortality. With multi-institutional collaboration, the purpose of this study was to analyze cross-continental differences of RCC with IVC tumor thrombus between patients in North America (NA), Central/South America (CSA), and Asia. METHODS: Patients with RCC who underwent nephrectomy with renal vein and/or IVC thrombectomy were retrospectively analyzed. Patients were from NA, CSA, and Asia. NA patients were all from the United States. CSA patients were from Mexico, Argentina, Brazil, Peru, Chile, and Uruguay. Asia patients were from South Korea. All comparisons were done based on the continent (NA, CSA, Asia) where a patient had their surgery and follow-up. Metastatic symptoms were defined as shortness of breath, bone pain, or neurologic symptoms. International Metastatic RCC Database Consortium (IMDC) scores were all calculated using an online scoring system. Chi-squared test, independent samples t-test, and analysis of variance were used for statistical testing. Any patient with a missing variable on review was excluded from analysis for that particular variable. RESULTS: The study included 312 patients (55 NA, 200 CSA, 57 Asia). All results are shown in Table 1. Of note, thrombus level was significantly different using both the Neves and Ciancio classification systems between continents (p<0.001), with a greater thrombus level in CSA patients. Surgical approach differed between continents, with laparoscopic cases done most often in CSA (p<0.001). Further, tumor grade (p<0.001) and stage (p<0.001) were significantly greater in CSA. A greater proportion of patients in CSA and Asia had metastatic disease compared to NA (p=0.034). Time to death after surgery was equivalent across continents (p=0.131). If metastases were present, time to death from initial diagnosis was quickest in CSA (p<0.001). CONCLUSIONS: Patients from NA, CSA, and Asia who are diagnosed with RCC and a tumor thrombus do not present the same and have different outcomes peri- and post-operatively. This includes important cancer-specific variables which have impacts on patient morbidity and mortality. Considering increased efforts on health equity in urology, the causes of these differences call for further investigation. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e91 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Maxwell Sandberg More articles by this author Mary Namugosa More articles by this author Rory Ritts More articles by this author Davis Temple More articles by this author Wyatt Whitman More articles by this author Claudia Marie-Costa More articles by this author Justin Refugia More articles by this author Benjamin Eilender More articles by this author Parth Thakker More articles by this author Mitchell Hayes More articles by this author Rafael Ribiero Zanotti More articles by this author Patricio Garcia Marchiñena More articles by this author Ashok Hemal More articles by this author Reza Mehrazin More articles by this author Philippe Spiess More articles by this author Stenio de Cassio Zequi More articles by this author Alejandro Rodriguez More articles by this author Expand All Advertisement PDF downloadLoading ...