Ureteral stent placement and percutaneous nephrostomy in the management of hydronephrosis secondary to cervical cancer

Tan, Shutao; Tao, Zijia; Bian, Xiaobo; Zhao, Yiqiao; Wang, Ning; Chen, Xiaonan; Wu, Bin

doi:10.1016/j.ejogrb.2019.08.020

Cited by 20 publications

(34 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 6 Hydronephrosis can lead to complications such as urinary tract infections, chronic low back pain, nausea, vomiting, bleeding, and chronic kidney failure. 19 Moreover, evidence suggests that radiotherapy may eventually induce acute urinary obstructive disease. 20 Thus, some authors consider early urinary diversion in cases of bilateral hydronephrosis with low creatinine clearance (<50 mL/min).…”

Section: Discussionmentioning

confidence: 99%

Prognostic role of hydronephrosis in the treatment of patients with locally advanced cervical cancer: a retrospective cohort

Nóbrega

Zanon

Andrade

et al. 2022

Int J Gynecol Cancer

View full text Add to dashboard Cite

BackgroundObstructive uropathy is present in almost 50% of patients with advanced cervical cancer and is associated with worse outcomes.ObjectiveTo estimate the prognostic role of hydronephrosis and the impact of ureteral obstruction resolution in patients with locally advanced cervical cancer undergoing treatment.MethodsA retrospective cohort study was conducted of patients with International Federation of Gynecology and Obstetrics 2018 stage IIIB to IVA treated in a tertiary oncologic referral center in Brazil between January 2009 and June 2018. Three different groups were evaluated: (I) without hydronephrosis, (II) with hydronephrosis and urinary diversion, and (III) with hydronephrosis but no urinary diversion. Kaplan-Meier curves and log-rank tests estimated overall survival and progression-free survival based on the presence of hydronephrosis and urinary diversion. Clinicopathological variables were evaluated using univariate and multivariate Cox proportional hazard regression model for overall survival and progression-free survival.ResultsA total of 151 patients were evaluated: group I – 62 (41.1%); II – 44 (29.1%), and III – 45 (29.8%). Stage, histological type or grade, tumor size, parametrial or lymph node involvement were not statistically different between groups. Group I had more favorable overall survival than groups II (p<0.003) and III (p<0.02); however, no difference was noted between groups II and III. Progression-free survival was similar between groups (log-rank test p=0.95). Univariate analysis revealed hydronephrosis (p=0.002) and concurrent chemoradiotherapy (p<0.001) as a prognostic factor for worse overall survival; while tumor size (p=0.023), pelvic lymphadenopathy (p=0.015), and histological type (p=0.03) were associated with worse progression-free survival. On multivariate analysis, hydronephrosis remained as an independently associated factor with worse overall survival (HR=2.06; 95% CI 1.12 to 3.79, p=0.02).ConclusionPatients with locally advanced cervical cancer with hydronephrosis had lower overall survival even after controlling for potential confounding factors, but no difference in progression-free survival. Urinary diversion showed no impact on overall survival or progression-free survival.

show abstract

Section: Discussionmentioning

confidence: 99%

Prognostic role of hydronephrosis in the treatment of patients with locally advanced cervical cancer: a retrospective cohort

Nóbrega

Zanon

Andrade

et al. 2022

Int J Gynecol Cancer

View full text Add to dashboard Cite

show abstract

“…10,11 Some patients fail to show significantly improved renal function after a urethral catheter is placed to relieve the obstruction. 12 Their severe symptoms of the internal environment disturbance such as azotaemia and hyperkalaemia are not corrected as soon as expected without significant changes in creatinine, urea nitrogen or serum potassium on the following day after the ureteral stent is placed. 13 For such patients, haemodialysis should be performed to decelerate the rapidly collecting toxins within the body and help patients to handle the critical stage, according to our experience.…”

Section: A H E a D O F P R I N Tmentioning

confidence: 96%

“…Though immensely harmful, renal function impairment can quickly recover once the obstruction is relieved by such surgical intervention measures as ureter catheterisation. 3 However, a small portion of patients may appear to have a slight improvement in post-surgical renal function so that they may still need further haemodialysis to improve the renal function and electrolyte disturbance, correct the state of internal toxicant accumulation, and get steadily through the critical stage to fight for a better chance for subsequent treatment.…”

Section: Introductionmentioning

confidence: 99%

A comparative analysis of high-flux and low-flux dialysis in cervical cancer patients with obstructive renal failure showing no significantly improved renal function after catheterisation

Zhang

Xie²,

Ao³

et al. 2021

Pak J Med Sci

View full text Add to dashboard Cite

Objective: This study aims to compare the clinical application value of high-flux dialysis with low-flux dialysis in patients without significantly improved renal function after cervical cancer and obstructive renal failure catheterisation. Methods: This prospective randomised study was conducted from January 2018 to December 2019. Eighty cervical cancer patients with obstructive renal failure who showed no significant renal function improvement after catheterisation were randomised into two groups (n = 40 in each group) in the Second People’s Hospital of Yibin City. High-flux and low-flux dialysis were employed in the experimental group and the control group, respectively. Treatments in both groups were provided every other day, with the whole course lasting one week. Data were recorded before and after dialysis included inflammatory factors such as IL-6, CRP and TNF-a, large and moderate molecular toxins (e.g., β2 micro-globulin, parathyrin (PTH) and cysteine protease inhibitor). Renal function changes during the dialysis were also recorded. Afterwards, the two groups were compared regarding the overall efficacy. Results: Both the experimental group and the control group experienced a significant decrease in IL-6, CRP, TNF-a, β2 micro-globulin, PTH and cysteine protease inhibitor, with the decrease in the experimental group being more evident (p < 0.05). After dialysis was completed, the experimental group restored renal function indicators such as Cre, CysC and serum K+ levels more quickly than the control group (p < 0.05). The effective rate was 100% for the experimental group and 87.5% for the control group. The intragroup difference in the efficacy.was significant. Conclusions: High-flux dialysis appears to be more beneficial for cervical cancer patients with obstructive renal failure, showing no significant improvement in renal function after catheterisation. It restored renal function more quickly, had more radical draining of inflammatory factors and large and moderate molecular toxins, and had a higher overall effective rate. doi: https://doi.org/10.12669/pjms.37.4.3515 How to cite this:Zhang C, Xie DQ, Ao L, Zhu L. A comparative analysis of high-flux and low-flux dialysis in cervical cancer patients with obstructive renal failure showing no significantly improved renal function after catheterisation. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.3515 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

show abstract

“…Urinary diversion in cases of obstructive uropathy due to advanced cervical cancer is needed to prevent deteriorating kidney function and has been proven to increase the chance of survival [6], [7]. The insertion of a double J (DJ) stent and the percutaneous nephrostomy is urinary diversion options that can be offered to the patients.…”

Section: Introductionmentioning

confidence: 99%

“…The insertion of a double J (DJ) stent and the percutaneous nephrostomy is urinary diversion options that can be offered to the patients. Although several studies have consistently discovered that percutaneous nephrostomy is slightly better in restoring kidney function, psychosocially, patients are more receptive to DJ stent insertion since it is generally accepted and may be left in place for long periods of time when necessary, without an external tube [7], [8], [9]. In palliative cases, the patient's preference is respected in accordance with the medical options provided [2], [9].…”

Section: Introductionmentioning

confidence: 99%

Predictor of Successful DJ Stent Insertion in Advanced Cervical Cancer

Santosa¹,

Prawira²,

Pramana³

et al. 2020

Open Access Maced J Med Sci

View full text Add to dashboard Cite

BACKGROUND: Metastatic cervical cancer in the ureter may lead to obstructive uropathy due to mechanical ureteral blockage. The insertion of a double J (DJ) stent is a urinary diversion option that can be offered to the patients, but it becomes challenging due to the high rate of failures. AIM: The aim of the study was to determine the factors that predict the success of DJ stent insertion in obstructive uropathy due to advanced cervical cancer. MATERIALS AND METHODS: The patients studied were those with obstructive uropathy due to advanced cervical cancer from 2017 to 2020 in Sanglah General Hospital. The research subjects were divided into two groups: First were the samples of successful DJ stent insertions and the second were those that failed. In the analysis, the Chi-square tests were used for categorical data, while the independent t-tests were used for normally distributed data. Logistic regression analyses which involved both the univariate and multivariate were conducted to determine the factors that aided the success of DJ stent insertions. RESULTS: Retrograde stent insertion of DJ stents was conducted on 100 patients. Successful insertions were found in 57 patients (57%), while those that failed were observed in 43 subjects (43%). The results of multivariate regression analyses showed that low-grade hydronephrosis (odd ratios [OR] = 62.024; p = 0.000; confidence interval [CI] = 9.485–405.596), normal albumin levels (OR = 5.856; p = 0.018; CI = 1.359–25.243), lower Federation of Gynecology and Obstetrics (FIGO) staging (OR = 14.985; p = 0.007; CI = 2.108–106.536), and a history of radiotherapy (OR = 8.758; p = 0.005; CI = 1.943–39.477) were the significant factors for predicting the success of DJ stent insertions. CONCLUSION: Low-grade hydronephrosis, normal albumin levels, lower FIGO staging, and a history of radiotherapy are the strong factors for predicting the success of DJ stent insertions in obstructive uropathy due to advanced cervical cancer.

show abstract

Ureteral stent placement and percutaneous nephrostomy in the management of hydronephrosis secondary to cervical cancer

Cited by 20 publications

References 15 publications

Prognostic role of hydronephrosis in the treatment of patients with locally advanced cervical cancer: a retrospective cohort

Prognostic role of hydronephrosis in the treatment of patients with locally advanced cervical cancer: a retrospective cohort

A comparative analysis of high-flux and low-flux dialysis in cervical cancer patients with obstructive renal failure showing no significantly improved renal function after catheterisation

Predictor of Successful DJ Stent Insertion in Advanced Cervical Cancer

Contact Info

Product

Resources

About