Publications by authors named "Margaret F Meagher"
Article Synopsis
- This study aimed to analyze how common surgically induced chronic kidney disease (CKD-S) is in patients with upper tract urothelial carcinoma (UTUC) after they undergo radical nephroureterectomy (RNU), focusing on survival outcomes.* -
- Researchers looked at data from 1,862 patients and found that 34.7% developed CKD-S3a and 39.6% developed CKD-S3b after surgery, with older age, lower preoperative kidney function, and certain chemotherapy treatments linked to higher risks of developing CKD-S3b.* -
- The study revealed that while CKD-S3b patients had worse overall survival rates (59% over 5 years), CK
Article Synopsis
- - The study aimed to create a preoperative tool called NODESAFE to predict nodal involvement (NI) in patients with localized renal cell carcinoma (RCC) before surgery, addressing the ongoing debate about the need for lymphadenectomy.
- - Researchers conducted a multicenter analysis of 3,308 RCC patients who had primary surgical resections, excluding those with clinical metastasis, using a stepwise logistic regression model to identify significant predictive factors for NI, achieving an AUC of 0.89 in validation.
- - The final NODESAFE model included factors like hypertension, tumor size, and CRP levels, demonstrating high sensitivity (83.9%) and specificity (86.1%), which could enhance clinical decision-making
Article Synopsis
- This study examines how the Mayo Adhesive Probability (MAP) score and body mass index (BMI) affect kidney function decline after patients undergo robotic assisted partial nephrectomy (RAPN).
- A total of 258 patients were analyzed over a median follow-up of 33 months, revealing that a higher MAP score and increased BMI are correlated with a greater risk of developing chronic kidney disease stage 3 (CKD-S3).
- The findings suggest that higher MAP scores and obesity can negatively impact long-term kidney function, indicating a need for careful monitoring before surgery in at-risk patients.
Article Synopsis
- This study compares outcomes of radical nephrectomy (RN) versus partial nephrectomy (PN) for treating sarcomatoid renal cell carcinoma (sRCC) using a large national database from 2004 to 2019.
- The analysis found that patients receiving PN had better overall survival rates, particularly in early-stage tumors (cT1 and cT3), although factors like age and tumor characteristics influenced the likelihood of receiving PN.
- The results suggest that PN can be a viable option for certain patients without compromising outcomes, but disparities in care exist based on income and insurance status, affecting survival rates.
Objective: To evaluate predictive ability of a novel combined index, Charlson comorbidity index and C-reactive protein (CCI-CRP), for outcomes in renal cell carcinoma (RCC), and compare predictive outcomes with of CCI-CRP to its separate components and to the UCLA integrated staging system (UISS).
Patients And Methods: We retrospectively analyzed INMARC registry of RCC patients. Receiver Operator Characteristics (ROC) analysis was fitted to identify threshold defining low-CRP (LCRP) and high-CRP (HCRP).
Objective: Stage migration in renal cell carcinoma (RCC) has led to an increasing proportion of diagnosed small renal masses. Emerging knowledge regarding heterogeneity of RCC histologies and consequent impact on prognosis led us to further explore outcomes and predictive factors in surgically-treated T1a RCC.
Methods: The INMARC database was queried for T1aN0M0 RCC.
Background: To evaluate relationship between histological subtypes of renal cell carcinoma (RCC) and preoperative c-reactive protein (CRP).
Patients And Methods: We queried the International Marker Consortium for Renal Cancer database for patients affected by RCC. Patients were classified according to their histology: benign tumors, clear cell (cc) RCC, chromophobe (ch) RCC, papillary (p) RCC, and variant histology (vh) RCC; and according to CRP (mg/L): low CRP ≤5 and high CRP >5.
Background And Objective: The role of cytoreductive nephrectomy (CN) in the treatment of metastatic renal cell carcinoma (mRCC) has been called into question on the basis of clinical trial data from the tyrosine kinase inhibitor (TKI) era. Comparative analyses of CN for patients treated with immuno-oncology (IO) versus TKI agents are sparse. Our objective was to compare CN timing and outcomes among patients who received TKI versus IO therapy.
View Article and Find Full Text PDF: to investigate the impact of age on renal function deterioration after robotic-assisted partial nephrectomy (RAPN) focusing on a decline to moderate and severe forms of chronic kidney disease (CKD). : This is a single center prospective analysis of patients who underwent RAPN. The outcomes include the development of de novo CKD-S 3a [estimated glomerular filtration rate (eGFR) < 60 mL/min/1.
View Article and Find Full Text PDFObjective: To investigate impact of body mass index (BMI) on survival across different histologies and stages of renal cell carcinoma (RCC).
Methods: We conducted a retrospective multicenter analysis of clear cell (ccRCC) and non-ccRCC. Obesity was defined according to the WHO criteria (non-Asian BMI >30 Kg/m, Asian BMI >27.
With the advent of new therapeutic modalities, management of metastatic castrate-sensitive prostate cancer (mCSPC) has been in flux. From androgen-deprivation therapy to docetaxel to androgen receptor-signaling inhibitors, each agent has heralded a new treatment paradigm. As such, the optimal first-line therapy for mCSPC remains incompletely defined.
View Article and Find Full Text PDFObjective: To report the results of PADRES (Prior Axitinib as a Determinant of Outcome of Renal Surgery, NCT03438708), a study investigating neoadjuvant axitinib for tumours of high complexity with imperative indication for partial nephrectomy (PN).
Methods: We conducted a single-arm phase II clinical trial of localized (cT1b-cT3M0) clear-cell renal cell carcinoma (RCC) patients with imperative indications for nephron preservation, where PN is a high-risk procedure due to complexity (RENAL score 10-12). Axitinib 5 mg was administered twice daily for 8 weeks with repeat imaging at completion, followed by surgery.
Objective: To create and validate 2 models called RENSAFE (RENalSAFEty) to predict postoperative acute kidney injury (AKI) and development of chronic kidney disease (CKD) stage 3b in patients undergoing partial (PN) or radical nephrectomy (RN) for kidney cancer.
Methods: Primary objective was to develop a predictive model for AKI (reduction >25% of preoperative eGFR) and de novo CKD≥3b (<45 ml/min/1.73m), through stepwise logistic regression.
Background: Utility of partial nephrectomy (PN) for complex renal mass (CRM) is controversial. We determined the impact of surgical modality on postoperative renal functional outcomes for CRM.
Methods: We retrospectively analyzed a multicenter registry (ROSULA).
Purpose: We hypothesized that two-tier re-classification of the "M" (metastasis) domain of the Tumor-Node-Metastasis (TNM) staging of Renal Cell Carcinoma (RCC) may improve staging accuracy than the current monolithic classification, as advancements in the understanding of tumor biology have led to increased recognition of the heterogeneous potential of metastatic RCC (mRCC).
Methods: Multicenter retrospective analysis of patients from the REMARCC (REgistry of MetAstatic RCC) database. Patients were stratified by number of metastases into two groups, M1 (≤3, "Oligometastatic") and M2 (>3, "Polymetastatic").
Purpose: To review the current status of surgical and procedural treatments for renal cell carcinoma (RCC), focusing on oncological and functional outcomes, and the use of techniques for advanced disease over the last 10 years.
Findings: Partial nephrectomy (PN) has become the reference standard for most T1 and T2 masses. In cT2 RCC, PN exhibits oncological equivalence and improved functional outcomes compared to radical nephrectomy (RN).
Purpose: To compare outcomes of robotic-assisted partial nephrectomy (RAPN) and minimally invasive radical nephrectomy (MIS-RN) for complex renal masses (CRM).
Methods: We conducted a retrospective multicenter analysis of CRM patients who underwent MIS-RN and RAPN. CRM was defined as RENAL score 10-12.
Introduction: We sought to determine whether loss of renal function increases risk of recurrence and metastases in renal cell carcinoma (RCC), and whether this impact was age-related.
Materials And Methods: We performed a retrospective analysis of the International Marker Consortium for Renal Cancer (INMARC) registry. Patients were separated into younger (<65 years old) and elder (≥65 years old) age groups, and rates of de novo estimated glomerular filtration rate (eGFR<45 mL/min/1.
To evaluate whether computer program-estimated urolith stone volume (SV) was a better predictor of spontaneous passage (SP) compared with program-estimated stone diameter (PD) or manually measured stone diameter (MD), and whether utilizing SV and MD together provided additional value in SP prediction compared with MD alone. Retrospective analysis of patients with acute renal colic and single renal/ureteral stone on CT from July 2017 to April 2020. Diameter obtained from radiology reports or manually measured when report not available.
View Article and Find Full Text PDFObjectives: To evaluate effects of worsening surgically induced chronic kidney disease (CKD-S) on oncological and non-oncological survival outcomes in renal cell carcinoma (RCC).
Patients And Methods: We performed a retrospective analysis of patients who underwent partial (PN) or radical nephrectomy (RN) and were free of preoperative CKD (estimated glomerular filtration rate [eGFR] ≥60 mL/min/1.73 m ).
Background: Treatment paradigms for management of metastatic renal cell carcinoma (mRCC) are evolving. We examined impact of surgical metastasectomy on survival across in mRCC stratified by risk-group.
Methods: Multicenter retrospective analysis from the Registry of Metastatic RCC database.
Objective: To investigate association of African-American race and survival in Renal Cell Carcinoma (RCC).
Patients And Methods: We queried the International Marker Consortium for Renal Cancer database for patients who underwent partial or radical (RN) nephrectomy. The cohort was divided into African American (AA) and non-African American (NAA) patients.
Objective: To determine the impact of health care system access on outcomes for Hispanic and Non-Hispanic White patients with renal cell carcinoma (RCC).
Methods: We retrospectively analyzed Hispanic and non-Hispanic White patients diagnosed with localized RCC between 2007 and 2020. We used Health Resources and Services Administration criteria to identify patients living in Medically Underserved Areas (MUA).
Importance: The association of the Patient Protection and Affordable Care Act (ACA) with insurance status and cancer stage at diagnosis among patients with renal cell carcinoma (RCC) is unknown.
Objective: To test the hypothesis that the ACA may be associated with increased access to care through expansion of insurance, which may vary based on income.
Design, Setting, And Participants: This retrospective cohort analysis included patients diagnosed with RCC from January 1, 2010, to December 31, 2016, in the National Cancer Database.
Background: We sought to analyze the usefulness of pretreatment C-reactive protein (CRP) as a predictor of survival and oncological outcomes in patients with renal cell carcinoma (RCC).
Methods: Retrospective international analysis of patients with RCC with pretreatment CRP values from 2006 to 2017. A CRP of more than >5 mg/L was deemed elevated.