Hispanics More Likely than Caucasians to Develop Major Complications after Radical Cystectomy
Vancouver, Canada—The odds of having a major complication after a radical cystectomy, which is performed as part of the treatment for bladder cancer, are higher for Hispanics than for Caucasians, researchers have found. They calculated that the rate of such complications was 23.53% for Hispanic Americans compared with 16.09% for Caucasian Americans.
“In the United States, Hispanic patients represent a minority of patients undergoing radical cystectomy but are associated with the highest odds of having a major complication compared to all other racial groups,” concluded Chenchen Feng, MD, Research Fellow in Medicine, Brigham and Women’s Hospital, Boston, and colleagues in a poster presented at the 2013 annual congress of the Société Internationale d’Urologie.
Dr Feng’s team analyzed data from the Perspective Rx Comparative Database, which includes information from 600 nonfederal hospitals across the country. They captured data on men who had a radical cystectomy between 2003 and 2010.
The study included 38,903 Caucasians; 2343 African Americans; 875 Hispanics; and 8864 men from other races. A lower percentage of men aged ≥75 years was found in the Hispanic and African-American groups versus the other 2 groups, among other differences, such as a larger percentage of Hispanic patients who had surgery in hospitals with more than 600 beds. Besides the higher rate of major complications after cystectomy in Hispanic patients, significant differences were also seen in surgical characteristics, such as a higher percentage of African-American patients not having lymph node dissection compared with Caucasian and Hispanic patients.
The odds ratio (OR) for major complications was 1.88 for Hispanic patients relative to Caucasians in a multivariate analysis (95% confidence interval [CI], 1.08-3.27; P = .02).
This OR difference remained significant when the analysis included only older patients (aged ≥65 years), at 1.82 (95% CI, 1.05-3.16; P = .03), but the OR difference lost its significance when only Medicare beneficiaries were included. The researchers believe that this indicates that being aged >65 years and being uninsured or underinsured (ie, not being covered by Medicare) may be responsible for some, although not all, of the racial disparity.