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6 days ago
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Roshini Claire Anthony, 18 hours ago

Patients with mild hypertension who are at low risk for cardiovascular disease (CVD) do not appear to derive mortality or CVD benefit from antihypertensive treatments, raising questions on the need for treatment in this population, according to a recent study from England.

Pearl Toh, 3 days ago
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Lower pathological stage seen in neoadjuvant chemo-treated patients with urothelial carcinoma

11 Jul 2018

Pathological stage distribution is lower in patients with high-risk upper tract urothelial carcinoma treated with neoadjuvant chemotherapy than in those treated with radical nephroureterectomy alone, reports a study.

The authors retrospectively analysed the records of 240 patients with upper tract urothelial carcinoma at The John Hopkins Hospital from 2003 to 2017 to evaluate differences in their pathological stage distribution.

Neoadjuvant chemotherapy was offered prior to radical nephroureterectomy to patients with biopsy-proven high-grade disease and a visible lesion on cross-sectional imaging (study group). A control group consisting of a time-matched cohort of patients with biopsy-proven high-grade disease underwent extirpative surgery alone. The authors assessed clinical and pathological variables between the cohorts via chi-square and Fisher exact tests.

Thirty-two patients in the study group and 208 in the control group were included in the analysis. The study group demonstrated significantly lower pathological stage compared with the control group (p<0.001).

There were significantly fewer patients with pT2 disease or higher treated with neoadjuvant chemotherapy (37.5 percent vs 59.6 percent; p=0.02). A 46.5-percent reduction was noted in the prevalence of pT3 disease or higher among patients without clinically node positive or low volume metastatic disease in the study group (25.9 percent vs 48.4 percent; p=0.04).

In addition, a 9.4-percent complete remission rate was observed in patients who underwent neoadjuvant chemotherapy.

“High-risk upper tract urothelial carcinoma has been associated with poor survival outcomes,” the authors said. “Limited retrospective data support neoadjuvant chemotherapy prior to radical nephroureterectomy.”

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Most Read Articles
6 days ago
Electroretinogram-assessed localized retinal dysfunction in type 1 diabetes mellitus patients appears to occur even in the absence of clinical signs of diabetic retinopathy (DR), and this incidence is associated with ageing, according to a study.
Roshini Claire Anthony, 18 hours ago

Patients with mild hypertension who are at low risk for cardiovascular disease (CVD) do not appear to derive mortality or CVD benefit from antihypertensive treatments, raising questions on the need for treatment in this population, according to a recent study from England.

Pearl Toh, 3 days ago
A personalized computerized neurofeedback intervention for training attention and memory shows potential in cognitive training for healthy elderly men, who improved in cognitive performance after the training, although no significant improvements were seen in the overall study population.
6 days ago
Greater home blood pressure (BP) variability, particularly in home systolic (S)BP, correlates with higher carotid, aortic and peripheral but not coronary atherosclerosis burdens independent of the mean home BP, suggests a recent study.