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6 days ago
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07 Oct 2018
Patients using long-acting opioids with immunosuppressive properties are at greater risk of developing serious infections compared with those using the nonimmunosuppressive opioid counterpart, according to a study.

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
6 days ago
Use of statin appears to reduce the risks of osteoporosis, hip fractures and vertebral fracture in patients newly diagnosed with a stroke, suggests a recent study.
3 days ago
Elderly adults using hypoglycaemic glucose-lowering drugs, such as insulin and glinides, have an excess risk of hospitalization for serious trauma, a recent study has found.
Pearl Toh, 5 days ago

The duration of dual antiplatelet therapy (DAPT) should be individualized based on ischaemic and bleeding risk of a particular patient, rather than focusing on a dualistic short- vs long-duration therapy thinking, advocates a leading expert during AFCC 2018.

07 Oct 2018
Patients using long-acting opioids with immunosuppressive properties are at greater risk of developing serious infections compared with those using the nonimmunosuppressive opioid counterpart, according to a study.