Health disparities among tennessee pediatric renal tumor patients.

Neuzil K, Apple A, Sybenga A, Chen H, Zhao S, Whiteside M, Correa H, Phelps HM, Lovvorn HN
J Pediatr Surg. 2020 55 (6): 1081-1087

PMID: 32173121 · DOI:10.1016/j.jpedsurg.2020.02.029

BACKGROUND/PURPOSE - Wilms tumor (WT) poses a cancer health disparity to black children globally, which has not been evaluated thoroughly for other pediatric renal cancers. We aimed to characterize health disparities among Tennessee children treated for any renal cancer.

METHODS - The Tennessee Cancer Registry (TCR) was queried for patients ≤18 years having any renal cancer (n = 160). To clarify treatment and outcomes, we performed a retrospective cohort study of pediatric renal cancer patients in our institutional cancer registry (ICR; n = 121). Diagnoses in both registries included WT, Sarcoma/Other, and Renal Cell Carcinoma. Wilcoxon/Pearson, Kaplan-Meier, and logistic regression were completed.

RESULTS - In both registries, WT comprised the most common renal cancer and youngest median age. Sarcoma was intermediate in frequency and age, and RCC was least common, having the oldest age (p < 0.001). In the TCR, black patients comprised 26% of all patients, presented more commonly with distant disease than white patients (37% v. 16%; p = 0.021), and showed worse overall survival (73% v. 89%; p = 0.018), while the ICR showed similar survival between race groups (92% v. 93%, p = 0.868). Sarcoma and metastases were independent predictors of death in both registries (p ≤ 0.002).

CONCLUSIONS - Black children in Tennessee presented with more advanced disease and experienced worse survival when combining all renal cancer types, particularly RCC and Sarcoma. When treated at a comprehensive pediatric cancer center, these survival disparities appear diminished.

TYPE OF STUDY - Prognostic study.

LEVEL OF EVIDENCE - Level II (retrospective cohort).

Copyright © 2020 Elsevier Inc. All rights reserved.

MeSH Terms (20)

Adolescent African Americans Carcinoma, Renal Cell Child Child, Preschool Cohort Studies European Continental Ancestry Group Female Healthcare Disparities Humans Infant Kidney Neoplasms Male Neoplasm Staging Registries Retrospective Studies Sarcoma Sarcoma Tennessee Wilms Tumor

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