Socioeconomic Predictors of Metastatic Clear-Cell RCC Identified

It is important to assess factors that may put patients at higher risk of metastatic disease, according to researchers.
It is important to assess factors that may put patients at higher risk of metastatic disease, according to researchers.

NEW ORLEANS—Older age, unmarried status, or white race are independent risk factors for metastatic clear-cell renal cell carcinoma (ccRCC) at the time of diagnosis, researchers revealed at the 2015 American Urological Association meeting in New Orleans.

For the study, the team led by Zachary Klaassen, MD, of the Medical College of Georgia-Georgia Regents University in Augusta, analyzed data for more than 63,589 ccRCC patients from the Surveillance, Epidemiology, and End Results (SEER) database 2004–2010. Metastatic disease was present at diagnosis in 9,623 patients (15%).

The researchers examined the effect of age, gender, race, marital status, health insurance status, and county wealth (i.e., median income, percentage of residents living in poverty, percentage unemployed, and percentage with less than a 9th-grade education).

Patients with metastatic cancer at diagnosis were more frequently older (age 65 vs. 63), male, and single, divorced, or widowed. They were also more likely to lack health insurance and to live in a neighborhood with more residents who were poorly educated and living in poverty.

These results coincide with research findings for other cancers, including non-urological malignancies and urothelial carcinoma of the bladder.

As advanced ccRCC is associated with poor prognosis, “there needs to be a heightened level of suspicion on the part of clinicians when suspecting metastasis in certain high risk patients,” Dr. Klaassen told Renal & Urology News. “Clinicians should be aware of the correlation between these risk factors and presentation of advanced disease at diagnosis, highlighting potential health care disparities and providing an opportunity to involve social services and other support mechanisms in an effort to improve early care.”

 

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