Prognostic factors and treatment of bilateral ureteral obstruction caused by advanced cervical cancer
10.3969/j.issn.1000-8179.2013.15.011
- VernacularTitle:晚期宫颈癌并发双侧输尿管梗阻40例治疗预后分析
- Author:
Shuxia CHENG
;
Huijun CHENG
;
Li WANG
- Publication Type:Journal Article
- Keywords:
cervical cancer;
ureteral obstruction;
ureteral stents;
radiotherapy;
prognosis
- From:
Chinese Journal of Clinical Oncology
2013;(15):923-925
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aimed to analyze the prognostic factor of bilateral hydronephrosis caused by advanced cervical cancer and evaluate its value of treatment. Methods:A total of 40 patients with bilateral ureteral obstruction secondary to cervical cancer were diagnosed through computerized tomography, radioactive nephrogram, and blood tests for renal function. The placement of retrograde internal double-J ureteral stents was performed under a cystoscope in 13 patients. The placement of antegrade internal double-J ureteral stents via percutaneous nephrostomy was performed in 25 patients. Two cases had external ureteral stents via percutaneous nephrostomy. Twenty-nine patients underwent radiotherapy after normalization of their blood urine nitrogen and creatinine levels. The prognostic value of the treatment and renal function before placement of ureteral stents and radiotherapy after placement of ureteral stents were analyzed. Results:The normalization rate of renal function after ureteral stenting was 91.3%(21/23). The median survival time was longer in patients with untreated cervical cancer than that in patients with recurrent cervical cancer (χ2=9.379, P=0.009). After ureteral stenting, the median survival time was longer in patients who underwent radiation therapy than that in patients untreated with radiation (χ2=17.329, P=0.000). The median survival time was not significantly influenced by renal function before placement of ureteral stents (χ2=1.37, P=0.242). Conclusion:The patient with bilateral ureteral obstruction from untreated cervical cancer or from recurrent pelvic disease after surgical therapy should be considered for ureteral stenting followed by appropriate radiation.