Vatsala Mundra, Zachary Melchiode, Jiaqiong Xu, Carlos Riveros Sabogal, Raj Satkunasivam, Christopher J D Wallis, Dharam Kaushik
{"title":"西班牙裔肾癌患者的治疗延迟:一项使用国家癌症数据库的超过15万患者的分析。","authors":"Vatsala Mundra, Zachary Melchiode, Jiaqiong Xu, Carlos Riveros Sabogal, Raj Satkunasivam, Christopher J D Wallis, Dharam Kaushik","doi":"10.1097/UPJ.0000000000000801","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Disparities have been documented in the outcomes of various cancers (eg, lung, colorectal, breast) among the Hispanic population compared with non-Hispanic White (NHW) patients. However, little is known about disparities in renal cell carcinoma (RCC) management despite worse outcomes for those with delays in treatment. The aim of this study was to investigate the disparities in (1) RCC presentation and (2) the time to treatment initiation between Hispanic and NHW patients.</p><p><strong>Methods: </strong>We conducted a comparative analysis using National Cancer Database data from 2004 to 2020 to evaluate disparities in RCC presentation and time to treatment initiation between Hispanic and NHW patients. To minimize inherent differences between the 2 groups, we used 1:1 greedy caliper propensity score matching.</p><p><strong>Results: </strong>After propensity score matching, we analyzed a cohort of 7798 Hispanic and NHW patients. Hispanic patients had an increased likelihood of presenting with clinical T2b RCC relative to NHW patients (odds ratio 1.28; 95% CI, 1.03-1.60) and were more likely to experience delays in surgery (HR, 1.08; 95% CI, 1.01-1.16; <i>P</i> = .017) or any other treatment (HR, 1.08; 95% CI, 1.01-1.16; <i>P</i> = .022). Hispanic patients also received chemotherapy later (HR, 1.49; 95% CI, 1.05-2.12; <i>P</i> = .027).</p><p><strong>Conclusions: </strong>Our data indicate that Hispanic patients often present with more advanced stages of RCC and are likely to experience delays in treatment. This study underscores significant disparities in the presentation and care of RCC between Hispanic and NHW patients, highlighting the need for targeted interventions to address these inequalities.</p>","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"371-379"},"PeriodicalIF":1.7000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Treatment Delays in the Hispanic Population With Renal Cell Carcinoma: An Analysis of Over 150,000 Patients Using the National Cancer Database.\",\"authors\":\"Vatsala Mundra, Zachary Melchiode, Jiaqiong Xu, Carlos Riveros Sabogal, Raj Satkunasivam, Christopher J D Wallis, Dharam Kaushik\",\"doi\":\"10.1097/UPJ.0000000000000801\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Disparities have been documented in the outcomes of various cancers (eg, lung, colorectal, breast) among the Hispanic population compared with non-Hispanic White (NHW) patients. However, little is known about disparities in renal cell carcinoma (RCC) management despite worse outcomes for those with delays in treatment. The aim of this study was to investigate the disparities in (1) RCC presentation and (2) the time to treatment initiation between Hispanic and NHW patients.</p><p><strong>Methods: </strong>We conducted a comparative analysis using National Cancer Database data from 2004 to 2020 to evaluate disparities in RCC presentation and time to treatment initiation between Hispanic and NHW patients. To minimize inherent differences between the 2 groups, we used 1:1 greedy caliper propensity score matching.</p><p><strong>Results: </strong>After propensity score matching, we analyzed a cohort of 7798 Hispanic and NHW patients. Hispanic patients had an increased likelihood of presenting with clinical T2b RCC relative to NHW patients (odds ratio 1.28; 95% CI, 1.03-1.60) and were more likely to experience delays in surgery (HR, 1.08; 95% CI, 1.01-1.16; <i>P</i> = .017) or any other treatment (HR, 1.08; 95% CI, 1.01-1.16; <i>P</i> = .022). Hispanic patients also received chemotherapy later (HR, 1.49; 95% CI, 1.05-2.12; <i>P</i> = .027).</p><p><strong>Conclusions: </strong>Our data indicate that Hispanic patients often present with more advanced stages of RCC and are likely to experience delays in treatment. This study underscores significant disparities in the presentation and care of RCC between Hispanic and NHW patients, highlighting the need for targeted interventions to address these inequalities.</p>\",\"PeriodicalId\":45220,\"journal\":{\"name\":\"Urology Practice\",\"volume\":\" \",\"pages\":\"371-379\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Urology Practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/UPJ.0000000000000801\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urology Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/UPJ.0000000000000801","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/23 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:与非西班牙裔白人(NHWs)相比,西班牙裔人群在各种癌症(肺癌、结直肠癌、乳腺癌)的预后方面存在差异。然而,尽管延迟治疗的结果较差,但对肾细胞癌(RCC)管理的差异知之甚少。本研究旨在探讨1)RCC表现和2)治疗开始时间(TTI)在西班牙裔和NHW患者之间的差异。患者和方法:我们使用2004-2020年的国家癌症数据库数据进行了比较分析,以评估西班牙裔和非西班牙裔患者在RCC表现和TTI方面的差异。为了尽量减少两组之间的内在差异,我们使用1:1贪婪卡尺倾向评分匹配。结果:在PSM后,我们分析了7798名西班牙裔和NHW患者。西班牙裔患者与非西班牙裔患者相比,出现临床T2b RCC的可能性更高(优势比[OR] 1.28;95%可信区间[CI] 1.03, 1.60),更有可能延迟手术(风险比[HR] 1.08;95% ci 1.01, 1.16;p=0.017)或任何其他治疗(HR 1.08;95% ci 1.01, 1.16;p = 0.022)。西班牙裔患者也接受了化疗(HR 1.49;95% ci 1.05, 2.12;p = 0.027)。结论:我们的数据表明,西班牙裔患者通常表现为更晚期的RCC,并且可能会延迟治疗。本研究强调了西班牙裔和国家卫生工作者在RCC的表现和护理方面的显著差异,强调了有针对性的干预措施来解决这些不平等的必要性。
Treatment Delays in the Hispanic Population With Renal Cell Carcinoma: An Analysis of Over 150,000 Patients Using the National Cancer Database.
Introduction: Disparities have been documented in the outcomes of various cancers (eg, lung, colorectal, breast) among the Hispanic population compared with non-Hispanic White (NHW) patients. However, little is known about disparities in renal cell carcinoma (RCC) management despite worse outcomes for those with delays in treatment. The aim of this study was to investigate the disparities in (1) RCC presentation and (2) the time to treatment initiation between Hispanic and NHW patients.
Methods: We conducted a comparative analysis using National Cancer Database data from 2004 to 2020 to evaluate disparities in RCC presentation and time to treatment initiation between Hispanic and NHW patients. To minimize inherent differences between the 2 groups, we used 1:1 greedy caliper propensity score matching.
Results: After propensity score matching, we analyzed a cohort of 7798 Hispanic and NHW patients. Hispanic patients had an increased likelihood of presenting with clinical T2b RCC relative to NHW patients (odds ratio 1.28; 95% CI, 1.03-1.60) and were more likely to experience delays in surgery (HR, 1.08; 95% CI, 1.01-1.16; P = .017) or any other treatment (HR, 1.08; 95% CI, 1.01-1.16; P = .022). Hispanic patients also received chemotherapy later (HR, 1.49; 95% CI, 1.05-2.12; P = .027).
Conclusions: Our data indicate that Hispanic patients often present with more advanced stages of RCC and are likely to experience delays in treatment. This study underscores significant disparities in the presentation and care of RCC between Hispanic and NHW patients, highlighting the need for targeted interventions to address these inequalities.