Although the natural history of small renal masses appears similar between racial groups, Black patients have worse survival, investigators reported at the Genitourinary Cancers Symposium.
In the Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) registry, 410 patients elected active surveillance (84% White, 16% Black) and 335 chose primary intervention. At a median 12.5 months, 66 of the 410 patients on active surveillance underwent delayed intervention for progressive disease or other reasons.
Within the active surveillance cohort, investigators found no racial differences in age, comorbidities, or tumor size. The median overall growth rate of the renal masses also did not differ significantly between Black and White patients: 0.04 vs 0.1 cm/year, Joseph G. Cheaib, MD, MPH, of The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, reported on behalf of his team.
Tumor size was comparable between patients with primary or delayed intervention. Black patients, however, had a significant 68% lower likelihood of delayed intervention compared with White patients.
Black patients also were significantly more likely to undergo radical nephrectomy: 24.6% vs 10.4%, Dr Cheaib’s team reported. Pathologic stage and grade were similar between groups. Papillary histology, however, was significantly more frequent among Black patients: 34.1% vs 19.9%.
Among the intervention group, 31 patients died. Black patients had a significant 2.5-fold increased risk for death.
The differences in histology, surgical approach, and survival between Black and White patients with small renal masses are puzzling, according to the investigators.
Further socioeconomic and molecular analyses will help elucidate biological differences and identify strategies to improve outcomes among patients with [small renal masses], Dr Cheaib’s team concluded in the study abstract.
Cheaib JG, Patel SH, Alam R, et al. Racial differences in the natural history of small renal masses: A prospective registry study. Paper presented at ASCO GU 2022; February 17-19, 2022. Abstract 295.