ORIGINAL ARTICLE Race effects on pathological and functional outcomes after robotic partial nephrectomy in a single academic tertiary care center Onder Kara 1 • Hiury S. Andrade 1 • Homayoun Zargar 1 • Oktay Akca 1 • Matthew J. Maurice 1 • Peter A. Caputo 1 • Daniel Ramirez 1 • Ercan Malkoc 1 • Charles S. Modlin 2 • Jihad H. Kaouk 1 Received: 22 October 2015 / Accepted: 12 January 2016 / Published online: 9 February 2016 Ó Springer-Verlag London 2016 Abstract To explore the potential effects of race on pathological outcomes of renal tumor and on kidney function preservation in the patients undergoing robotic partial nephrectomy (RPN) at our center. Retrospective review of our institutional review board approved database for African-American (AA) patients undergoing RPN from 2006 to 2014 was performed. AA and non-AA groups were compared with regards to demographics, tumor character- istics, functional data and, oncological outcomes. For functional outcomes, groups were matched (1:1) in terms of age, preoperative estimated glomerular filtration rate (eGFR) and R.E.N.A.L score. From the total of 1005 patients, 84 were AA. Age and the tumor size were com- parable between the two groups (2.7 vs. 3 cm; p = 0.29). Proportion of patients with papillary RCC was higher among AAs compared to non-AAs (43.3 vs. 19.4 %; p \ 0.001). After matching AA patients with non-AA counterparts (1:1 matching), eGFR preservation at latest follow up after surgery was comparable between groups (84.3 vs. 85 %; p = 0.25). AA race (OR 3.62, p \ 0.001), male gender (OR 2.05, p \ 0.001) and low preoperative eGFR (OR 0.97, p \ 0.001) were predictors of papillary RCC on multivariate analyses. The incidence of papillary RCC is higher in AA patients undergoing RPN. There was no difference in kidney function recovery after robotic partial nephrectomy in both AA and non-AA groups. AA race itself is not a significant factor in determining renal malignancy. Further studies are needed to clarify the impact of higher prevalence of papillary tumors in AA group in terms of long-term oncological and functional outcomes. Keywords Robotic Á Partial nephrectomy Á Race Á African American Á Health disparities Introduction Renal cancer constitutes 2–3 % of all adult cancers, and is the third most frequent urological malignancy [1]. Obser- vation that Renal Cell Carcinomas (RCC) with similar pathological staging lead to different prognoses suggests that there are additional factors involved in determining the biological behavior of RCC, and race is potentially one of such factors [2]. The incidence of RCC has risen more rapidly in the African-American (AA) population com- pared to non-AA patients in the United States [3]. The Surveillance, Epidemiology and End Results (SEER) based study reported the age-adjusted incidences of RCC as 17, 14.3, 7.5 and 7.2 individuals/year out of 100,000 people in AA males, non-AA males, AA females, and non-AA females, respectively [3]. Race is also an important parameter for determination of estimated glomerular fil- tration rate (eGFR) [4]. Our aim was to explore the potential effects of race on kidney function preservation and on pathological outcomes of renal tumor in patients who underwent robotic partial nephrectomy (RPN) at our center. & Jihad H. Kaouk kaoukj@ccf.org Onder Kara onerkara@yahoo.com 1 Center for Laparoscopic and Robotic Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44016, USA 2 Section of Renal Transplantation, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA 123 J Robotic Surg (2016) 10:5–10 DOI 10.1007/s11701-016-0562-3