MP45-15 IMPACT OF PREOPERATIVE WAIT TIME ON RENAL CELL CARCINOMA TUMOR CHARACTERISTICS AND RACIAL AND ETHNIC DISPARITIES

INTRODUCTION AND OBJECTIVE: Natural and humancaused disasters, such as the COVID-19 pandemic, often have bigger negative effects on health status and healthcare access of racial/ethnic minority patients. The purpose of this study was two-fold, to assess if 1) a longer surgical wait time (SWT, ≥ 90 days) affects renal cell carcinoma (RCC) tumor characteristics at nephrectomy and 2) race/ethnicity was associated with a longer SWT and upstaging in the pre-COVID-19 pandemic time with focus on Hispanic Americans (HAs) and Native Americans (NAs) who have heavier burden of RCC in Arizona. METHODS: Medical records of patients diagnosed with RCC who underwent nephrectomy between 2010 and 2020 (through March, before the COIVD-19 pandemic worsened) at Banner-University Medical Center Tucson were reviewed (n=489). Patients with a prior cancer diagnosis were excluded. SWT was defined as the date of diagnostic imaging examination (e.g., CT and MRI) to date of nephrectomy. Logistic regression analysis was performed to assess if race/ethnicity was associated with longer SWT or upstaging. RESULTS: A total of 393 patients were included, 34.2% and 8.3% of patients were HAs and NAs respectively. While 49.2% of HA patients had a longer SWT, only 36.1% of non-Hispanic White (NHW) patients had a longer SWT. Longer SWT did not have a significant impact on tumor characteristics. Tumor size increased (≥ 2cm) in 9.9% of patients with a longer SWT, while 8.9% of patients with a shorter SWT had increased tumor size. Pathologic upstaging was seen in 26.4% and 25.7% of patients with longer and shorter SWT, respectively. Patients with public insurance coverage had increased odds of longer SWT (OR, 2.89;95% CI: 1.53-5.45). Public insurance coverage was higher among HAs and NAs, representing 66.1% and 70.0% of coverage compared to 56.7% in NHWs. Compared to NHWs, HAs had significantly increased odds of a longer SWT in patients with early-stage RCC (TNM Stage I or II) (OR 2.38, 95% CI: 1.25-4.53). HAs and NAs had increased odds of upstaging (OR 2.24, 95% CI: 1.07-4.66 for HAs and OR 3.79, 95% CI: 1.32-10.88 for NAs). Among patients with