The Importance of Downstaging: When LT Is Feasible?
In this sense, tumor downstaging may facilitate LT for patients with HCC outside MC; however, there is no optimal protocol yet and downstaging outcomes are poorly defined [66].
The secondary outcome was the
downstaging effect, which was defined as the rate of posttreatment reduction of pathological stage (including both T and/or N categories) as compared with the pretreatment clinical stage.
Radtke and colleagues first reported a markedly improved clinical outcome in patients who had pathologic
downstaging by neoadjuvant chemotherapy of the urinary bladder.
SNFs are required to report healing pressure ulcers in a sequence of "downstages," but there is no scientific rationale for
downstaging. Wounds do not heal in this manner, but SNFs currently have no other option for presenting clinical documentation.
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. A complete pathologic response was obtained in 9 patients (41%); 16 patients (72%) had no residual metastatic lymphadenopathy.
A subsequent PET scan proved that the spots were not tumor cells, thereby
downstaging the patient from clinical Stage IV to Stage I.
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.
This multimodal treatment has the potential to induce tumor downsizing and tumor
downstaging and possibly improve sphincter preservation and local control [1-3].
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.
In general, trials with an overall treatment time longer than 10 days have demonstrated that preoperative radiation has a
downstaging effect, the investigators note.