Radtke and colleagues first reported a markedly improved clinical outcome in patients who had pathologic downstaging by neoadjuvant chemotherapy of the urinary bladder.
It is not clear whether neoadjuvant chemotherapy is also effective for upper urinary tract tumours, but good prognosis has been reported in patients with pathological downstaging.
The pathological downstaging and long-term survival in our case support the usefulness of neoadjuvant chemotherapy in treating primary SCC of the upper urinary tract.
SNFs are required to report healing pressure ulcers in a sequence of "downstages," but there is no scientific rationale for downstaging
By upstaging or downstaging
disease, this hybrid imaging tool may alter the management of more than one-third of patients with the disease," said Dr.
Of the 22 patients who underwent surgery, 14 (64%) showed a pathologic downstaging
From a reimbursement standpoint, the use of reverse or downstaging in long-term care stems from wound care coverage criteria - the providers' use of the resident assessment instrument (RAI) for clinical protocol.
While most long-term care providers are, at this point, downstaging, there are some who are adopting a "once a stage IV, always a stage IV" stance.
If, for example, you have a surveyor who believes you should not be downstaging, yet HCFA mandates that you do so, you may end up with deficiencies that are not warranted under the guidelines.
A secondary objective was to compare the pT0 and tumour downstaging rates in patients who received radical cystectomy alone against those who received cispatin and gemcitabine (CG) neoadjuvant chemotherapy and radical cystectomy.
Secondary outcomes were differences between patients treated with radical cystectomy alone and those treated with neoadjuvant chemotherapy plus radical cystectomy with regard to pT0 and pathologic tumour downstaging.
In general, trials with an overall treatment time longer than 10 days have demonstrated that preoperative radiation has a downstaging
effect, the investigators note.