Patients who have no symptoms at presentation with T3 low-grade tumors and negative lymph nodes experience favorable survival following resection of locally-advanced, non-metastatic renal cell carcinoma (RCC), a recent retrospective study finds.

Investigators led by Paul Russo, MD, a urologic oncology surgeon at Memorial Sloan Kettering Cancer Center in New York, reviewed the medical records of 802 patients at the center who had nephrectomy (74% radical nephrectomy, 26% partial nephrectomy) for non-metastatic stage T3 or T4 RCC from 1989 to 2012. Most had open surgery with or without adrenalectomy or lymphadenectomy. The researchers focused on survival following surgical management of the disease, excluding patients receiving adjuvant treatment.

RCC progressed in 189 patients and 104 patients died from the disease, according to results published in the Journal of Urology (2015;193:1911-1917). The researchers determined that the following factors were significantly linked to progression-free and overall survival: symptoms at presentation, American Society of Anethesiologists (ASA) classification, tumor stage, histological subtype, grade, and lymph node status.  

The overall 10-year progression-free survival (PFS) rate among patients with clear-cell RCC was 65%, but it differed by AJCC tumor classifications. The PFS rate was 72% in patients with T3 tumors compared with 23% in those with T4 tumors. The 10-year PFS rate was 76% for patients with low-grade clear-cell tumors compared with 55% for patients with high-grade clear-cell tumors.

A high ASA classification was associated not only with worse overall survival but also with disease progression. “Many mechanisms have been proposed for this observation, including a proneoplastic state due to chronic immunosuppression related to renal failure associated uremia,” the investigators suggested.

Compared with patients who had T3 tumors, those who had T4 tumors had a 2.7 times increased risk of disease progression and a 3.4 times increased risk of death, in multivariable analysis. Patients who had local or systemic symptoms at presentation had a 2.3 times and 1.6 times increased risk of progression and death, respectively. Patients with positive lymph nodes had a 3.1 times and 1.5 times increased risk of progression and death compared with patients who had negative lymph nodes. Patients with high-grade tumors had a 62% and 48% increased risk of progression and death compared with those who had low-grade tumors.

The researchers also highlighted a trend toward “more selective use” of adrenalectomy over the years. “Our current practice is to perform adrenalectomy for bulky tumors and in patients with radiographic or intraoperative evidence of adrenal involvement,” they stated. Use of lymphadenectomy increased, especially among younger patients and those with large tumors.    

1. Bazzi, WM, et al. The Journal of Urology; doi: 10.1016/j.juro.2014.12.022.

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LAWRENCE, Mass., June 3, 2015 /PRNewswire/ -- NxStage Medical, Inc. (Nasdaq: NXTM), a leading manufacturer of dialysis products, today announced data that home hemodialysis can save California 221 million gallons of water annually by transitioning just 20 percent of its in-center dialysis patients to home hemodialysis with the NxStage® System One?.  Industry data shows conventional in-center dialysis uses approximately 429 gallons of water per patient per week, whereas home hemodialysis with the NxStage System One uses only 30 gallons of water per patient per week.

The above infographic illustrates the dramatic impact home hemodialysis with the System One can have on water consumption in the state of California.

About the NxStage System One
The NxStage System One is the first and only truly portable hemodialysis system cleared specifically by the FDA for home hemodialysis and home nocturnal hemodialysis. Its simplicity and revolutionary size (just over a foot tall) are intended to allow convenient use in patients' homes and give patients the freedom to travel with their therapy. When combined with the NxStage PureFlow SL Dialysis Preparation System, patients are able to further simplify, using ordinary tap water to create dialysis fluid on demand. Unlike conventional hemodialysis systems, the System One requires no special infrastructure to operate. Under the guidance of their physician, patients can use the NxStage System One, with their trained partners, where, how and when it best meets their needs, including while they are sleeping - at home or on vacation and at a medically appropriate treatment frequency. http://www.nxstage.com/.

About NxStage Medical
NxStage Medical Inc. (Nasdaq: NXTM) is a medical device company, headquartered in Lawrence, Massachusetts, USA, that develops, manufactures and markets innovative products for the treatment of ESRD and acute kidney failure. For more information on NxStage and its products, please visit the Company's website at www.nxstage.com.

Forward-Looking Statements
This release contains "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995. All statements contained in this release that are not clearly historical in nature are forward-looking, and the words "anticipate," "believe," "expect," "estimate," "plan," and similar expressions are generally intended to identify forward-looking statements. Actual results may differ materially from those indicated by these forward-looking statements as a result of various important factors including those that are discussed in NxStage's filings with the Securities and Exchange Commission, including the Quarterly Report on Form 10-Q for the quarter ended March  31, 2015. NxStage is under no obligation to (and expressly disclaims any such obligation to) update or alter its forward-looking statements, whether as a result of new information, future events or otherwise.

Media contact:
Kristen K. Sheppard, Esq.
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Tel: (978) 332-5923

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To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/home-hemodialysis-with-nxstage-system-one-can-save-california-221-million-gallons-of-water-annually-300093376.html

SOURCE NxStage Medical, Inc.

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