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In advanced-stage, newly diagnosed classical, CD30-positive Hodgkin lymphoma (HL), front-line therapy has resulted in durable remission rates in up to 70–90% of patients, although approximately 25–30% of advanced stage HL patients are refractory or relapse following first-line treatment with ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy.1–3 The standard of care for patients with relapsed or refractory (r/r) classical HL is salvage therapy using second-line high-dose chemotherapy (HDCT), followed by autologous haematopoietic stem cell transplant (ASCT) in eligible patients, which can induce a complete remission (CR) in about 50% of patients.4 Nevertheless, the prognosis of patients who relapse after the salvage HDCT/ASCT is exceedingly poor, with a median survival duration of approximately 1.2 years.5

Renal function recovery after radical nephrectomy more likely in patients with lower preoperative EGFR

11 Apr 2018

Recovery to preoperative renal function occur within 2 years in a large proportion of patients after undergoing radical nephrectomy for kidney tumours, a recent study has confirmed, adding that recovery is more probable among those with a lower preoperative estimated glomerular filtration rate (EGFR).

Nearly half of the patients (45 percent) had recovered to the preoperative EGFR by 2 years following radical nephrectomy. Renal function recovery also differed based on preoperative renal function, such that those with a lower preoperative EGFR had greater chance of recovery.

Furthermore, female patients and those who had larger tumour size were likely to have a better chance of renal recovery function.

In this multicentre retrospective study, the investigators sought to confirm the findings from a previous single-institution study of 572 patients from Memorial Sloan Kettering Cancer Centre, in which they found that 49 percent of patients recovered to the preoperative EGFR within 2 years following radical nephrectomy for renal cell carcinoma.

A total of 1,928 patients were included in the study, which used data sourced from three independent centres. The primary outcome was postoperative recovery to the preoperative EGFR. The investigators analysed data using cumulative incidence and competing risks regression with death from any cause treated as a competing event.

A Japan study found that patients who had deteriorated renal function immediately after radical nephrectomy recovered over time, but those with chronic kidney disease, diabetes mellitus, cardiovascular disease and hypertension did not tend to recover renal function postoperatively. Independent risk factors for a >50-percent EGFR decrease included greater age and diabetes mellitus. [Int J Urol 2016;23:219-223]

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Most Read Articles
Yesterday
In advanced-stage, newly diagnosed classical, CD30-positive Hodgkin lymphoma (HL), front-line therapy has resulted in durable remission rates in up to 70–90% of patients, although approximately 25–30% of advanced stage HL patients are refractory or relapse following first-line treatment with ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy.1–3 The standard of care for patients with relapsed or refractory (r/r) classical HL is salvage therapy using second-line high-dose chemotherapy (HDCT), followed by autologous haematopoietic stem cell transplant (ASCT) in eligible patients, which can induce a complete remission (CR) in about 50% of patients.4 Nevertheless, the prognosis of patients who relapse after the salvage HDCT/ASCT is exceedingly poor, with a median survival duration of approximately 1.2 years.5