• Urology · Apr 2016

    Comparative Study

    Racial Disparities in Partial Nephrectomy Persist Across Hospital Types: Results From a Population-based Cohort.

    • Jonathan E Kiechle, Robert Abouassaly, Cary P Gross, Shan Dong, Edward E Cherullo, Hui Zhu, Quoc-Dien Trinh, Maxine Sun, Neal J Meropol, Christopher J Hoimes, Sarah Ialacci, and Simon P Kim.
    • University Hospitals Case Medical Center, Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Urology Institute, Cleveland, OH.
    • Urology. 2016 Apr 1; 90: 69-74.

    ObjectiveTo assess the national utilization of partial nephrectomy (PN) for T1a renal masses across different racial groups by hospital type. Although clinical guidelines recommend PN for small renal masses (SRMs), racial disparities persist in the use of PN. High-volume and academic hospitals have been associated with greater use of PN for SRMs. However, it is unknown whether racial disparities persist in the use of PN across different types of hospitals.MethodsUsing the National Cancer Database, we identified patients with localized T1a renal cancer (≤4 cm) from 1998 to 2011. The primary outcome was receipt of PN among patients surgically treated for SRMs. Multivariable logistic regression analyses were used to assess for racial differences in treatment with PN stratified by hospital characteristics.ResultsAmong 118,207 patients diagnosed with clinical T1a renal masses, 36.5% underwent PN (n = 43,134). Overall, a greater proportion of white patients underwent PN (37.3%) compared with African-American (32.4%) and Hispanic (33.7%) patients with SRMs (P <.001). When stratified by hospital type, disparities persisted in the use of PN; African-American patients had lower adjusted odds ratios for being treated with PN when treated at comprehensive community cancer (odds ratio: 0.90; P = .003) and academic (odds ratio: 0.65; P <.001) hospitals compared with white patients.ConclusionsIn this population-based cohort, we found that racial disparities persist across all types of hospitals in the use of PN for SRMs. Further research is needed to identify, and target for intervention, the factors contributing to racial disparities in the surgical management of SRMs.Copyright © 2016 Elsevier Inc. All rights reserved.

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