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Serious infection may improve survival in renal cell carcinoma

05 Nov 2017

Perioperative infection following nephrectomy appears to improve cancer-specific survival in patients with T2 (≥7 cm) renal cell carcinoma, according to a recent study.

Researchers conducted a retrospective cohort study using Surveillance, Epidemiology and End Results (SEER)-Medicare claims data from 2004 to 2011. They also used International Classification of Diseases (ICD)-9 and Current Procedural Terminology (CPT) codes to identify patients >65 years who underwent radical or partial nephrectomy for renal cell carcinoma.

Those hospitalized for infection within 30 days of surgery were identified. Patients who died within 90 days of surgery, had immunodeficiency and metastatic disease at diagnosis were not included.

Researchers used Kaplan-Meier curves to assess cancer-specific survival between infection and no infection groups. A Cox proportional hazards models was developed to evaluate survival while controlling for age, gender, race, Elixhauser index, tumour grade, tumour size, histological subtype, American Joint Committee on Cancer stage, systemic therapy and geographic region.

A total of 8,967 patients were identified. Of these, 493 (5.5 percent; median age 74 years; mean Elixhauser index, 4.9) were hospitalized for infection after nephrectomy, with a follow-up of 42 months.

Univariable Cox regression revealed a nonsignificant improvement in cancer-specific survival in patients with a serious infection requiring hospitalization following nephrectomy (hazard ratio [HR], 0.84; 95 percent CI, 0.69 to 1.00; p=0.054). In Cox multivariable regression, there was a significant improvement in cancer-specific survival for the same population (HR, 0.75; 0.57 to 0.99; p=0.04).

Such improvement was seen only in patients with larger (≥7 cm) tumours (HR, 0.67; 0.44 to 0.99; p=0.049). There was no impact found among patients with smaller (<7 cm) tumours (HR, 0.82; 0.57 to 1.19; p=0.3).

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Most Read Articles
18 Apr 2018
Higher intake levels of coffee appear to be associated with reduced risk of developing chronic kidney disease, according to data from the Atherosclerosis Risk in Communities Study.
Jairia Dela Cruz, 5 days ago
Infants delivered via caesarean section may be at increased risk of developing acute lymphoblastic leukaemia, according to a US study. Altered microbiota colonization is a possible explanation for this risk, although clear biological mechanisms have yet to be established.
5 days ago
Treatment with danegaptide does not improve myocardial salvage in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention, according to the results of a phase II study.
4 days ago
Men with high levels of exposure to diesel exhaust are at greater risk of developing amyotrophic lateral sclerosis (AML), as shown in a recent study. This is not true for women.