Management of Obstructive Uropathy Patients with Advanced Prostate Cancer – A Systematic Review

Röllig, Christoph; Wöckel, Achim; Weißbach, L.

doi:10.1159/000242250

Cited by 9 publications

(7 citation statements)

References 13 publications

(26 reference statements)

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“…2 A larger review looking at prostate cancer suggested there was no consensus on how to manage BUO in advanced disease. 3 Individual case series on breast and esophageal cancer suggested ureteric diversion reversed the kidney injury and allowed further treatment of the systemic disease. 4,5 Despite the controversy in the management of this condition and the accepted poor prognosis, most patients receive percutaneous nephrostomy tubes (PNTs), retrograde ureteric stents or both.…”

Section: Introductionmentioning

confidence: 99%

“…Multiple studies have shown both stents and nephrostomy tubes are effective methods to restore kidney function after ureteric obstruction. 2,3,10,[16][17][18][19] Advancements in and availabil- There was a trend toward a decreasing percentage in the number of patients presenting with BUO secondary to cervical cancer compared with 1982. It is possible that aggressive screening for cervical cancer over the past 25 years contributed to this observation.…”

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confidence: 99%

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Acute reversible kidney injury secondary to bilateral ureteric Obstruction

Organ¹,

Norman²

2011

cuaj

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Background: Acute reversible kidney injury (ARKI) secondary to bilateral ureteric obstruction (BUO) is a common urological problem. Our goals were to describe the etiology, management and outcomes of such patients identified between 2006 and 2009 and to compare them with a similar historical study published in 1982. Methods: Chart review was performed on 49 patients with AKRI secondary to BUO. ARKI was defined as ≥33% decrease in serum creatinine after intervention. Those with malignant and benign causes of obstruction were identified and management and outcome data were collected. Results: Of these 49 patients, 83% had BUO secondary to malignancy, 28% of these presenting for the first time. Prevalence of bladder cancer was increased (p = 0.04) and cervix trended lower (p = 0.07) compared with the earlier study; prostate cancer was unchanged (p = 0.51). The average survival was 239 days; 90% of patients died within a year after presenting with BUO from a malignant etiology. Compared with the 1982 group, there were trends towards a decrease in the frequency of retroperitoneal fibrosis (p = 0.08) and an increase in bilateral ureteric calculi (p = 0.16) in the benign group. Conclusions: Patients with ARKI secondary to BUO most likely have an underlying malignancy, with almost a third of them being diagnosed for the first time. Prevalence of bladder cancer increased while cervical cancer trended lower. The cause for the former is unclear; the latter may be due to aggressive screening. Prostate cancer remained unchanged despite the widespread implementation of prostate-specific antigen testing. Patients with an underlying malignancy do poorly and those with a newly diagnosed malignancy do worst. Those with ARKI secondary to benign causes did well.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Acute reversible kidney injury secondary to bilateral ureteric Obstruction

Organ¹,

Norman²

2011

cuaj

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“…Furthermore, baseline characteristics between the single polymeric IUS and PCN groups, as well as other contributing factors, such as overall survival, often differ between studies. 59 Management of MUO by either single polymeric IUS or PCN drainage results in similar complication rates. Ku and colleagues 60 demonstrated no significant difference in the incidence of overall complications between the two groups (11% for the stent group vs 8.8% for the PCN group).…”

Section: Comparison Of Endoscopic Options For Upper Tract Obstructionmentioning

confidence: 96%

Obstructive Uropathy from Locally Advanced and Metastatic Prostate Cancer: An Old Problem with New Therapies

Friedlander

Duty

Okeke

et al. 2012

Journal of Endourology

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Despite stage migration to more organ-confined disease in the era of prostate-specific antigen, the complications of advanced prostate cancer are still relatively common. Urinary tract obstruction in advanced and metastatic prostate cancer can have a varied presentation, because it may occur in multiple anatomic locations at any point in the natural history of the disease. In all cases, management depends on the current stage of disease, technical feasibility of potential therapeutic interventions, and overall prognosis of the patient. This review highlights a practical approach to the evaluation, diagnosis, and management of obstructive uropathy from prostate cancer.

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“…Relevant literature and expert clinicians (M.P., H.P., N.C., J.S.A.G.) were consulted to identify relevant ICD-10 and OPCS-4 codes following the steps detailed below [12,13] (Appendix 1).…”

Section: Codingmentioning

confidence: 99%

Interventions for obstructive uropathy in advanced prostate cancer: a population‐based study

et al. 2022

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To develop and validate a coding framework to identify interventions for upper tract obstructive uropathy (UTOU) in men with locally advanced and metastatic prostate cancer (PCa) using administrative hospital data to assess clinical outcomes. There are no population-based studies on the incidence, treatment, and outcomes of this complication. Patients and MethodsPatients newly diagnosed with PCa between April 2014 and March 2019 were identified in the English cancer registry. A coding framework based on procedure (Office of Population Censuses and Surveys Classification of Surgical Operations and Procedures fourth edition) and diagnostic (International Classification of Diseases, 10th edition) codes was developed and validated. Subsequent clinical outcomes were determined using Hospital Episodes Statistics to determine the utility of the intervention. ResultsA total of 77 010 patients newly diagnosed with locally advanced, and 30 083 patients with metastatic PCa were identified. Of these, 1951 (1.8%) patients underwent an intervention for UTOU according to our coding framework: 830 (42.5%) had locally advanced disease and 1121 (57.5%) had metastatic disease. In all, 844 (43.3%) had a percutaneous nephrostomy (PCN), 473 (24.2%) had a PCN with antegrade stent, and 634 (32.5%) had a retrograde stent. The mean follow-up was 43.2 months. The cumulative incidence of the use of these interventions at 1, 3, and 5 years was 2.5%, 3.6% and 4.2% in men with metastases compared to 0.5%, 0.9% and 1.4% in men with locally advanced disease. ConclusionA new coding framework, developed to identify procedures for UTOU was applied in the largest study to date of UTOU in men with primary locally advanced and metastatic PCa. Results demonstrated that 2% of men with locally advanced PCa and 4% of men with metastatic PCa require an intervention to resolve UTOU within 5 years of their PCa diagnosis.

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Management of Obstructive Uropathy Patients with Advanced Prostate Cancer – A Systematic Review

Cited by 9 publications

References 13 publications

Acute reversible kidney injury secondary to bilateral ureteric Obstruction

Acute reversible kidney injury secondary to bilateral ureteric Obstruction

Obstructive Uropathy from Locally Advanced and Metastatic Prostate Cancer: An Old Problem with New Therapies

Interventions for obstructive uropathy in advanced prostate cancer: a population‐based study

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