Factors Affecting Survival Outcome After Percutaneous Nephrostomy as Palliative Urinary Diversion in Obstructive Uropathy due to Advance Cervical Cancer Patients

Noegroho, Bambang Sasongko; Kurniawan, Andri Pratama; Wijayanti, Zola; Mustafa, Akhmad

doi:10.31557/apjcp.2021.22.4.1211

Cited by 12 publications

(20 citation statements)

References 27 publications

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“…Previous reports suggest that older age, metastatic disease, and lower Eastern Cooperative Oncology Group (ECOG) performance status are factors associated with lower survival rates in cancer patients undergoing PCN. 10,11,38 Type of malignancy, low serum albumin before PCN (⩽3.5 gm/dl), low grade or bilateral hydronephrosis, and previously malignant ureteral obstruction were also associated with poor prognosis. 10,38,39 In our study, the relationship with age was not found, however, metastatic disease, and advanced oncological diseases with direct ureteral or kidney invasion have also been related to poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…9 Factors such as age, male sex, and preexisting chronic kidney disease (CKD) have been associated with an increased risk of PR–AKI. 9 –11 The most common cause is ureteral obstruction secondary to an advanced oncological process (such as prostatic, bladder, and kidney cancers) or secondary to extrinsic compression of the urinary tract by primary or metastatic abdominal disease, retroperitoneal lymphadenopathy, or by direct pelvic malignancies invasion. 6,9,12…”

Section: Introductionmentioning

confidence: 99%

“…9 Factors such as age, male sex, and preexisting chronic kidney disease (CKD) have been associated with an increased risk of PR-AKI. [9][10][11] The most common cause is ureteral obstruction secondary to an advanced oncological process (such as prostatic, bladder, and kidney cancers) or secondary to extrinsic compression of the urinary tract by primary or metastatic abdominal disease, retroperitoneal lymphadenopathy, or by direct pelvic malignancies invasion. 6,9,12 AKI is associated with significant morbidity and mortality 1,2 since it impacts the institution of optimal chemotherapy regimens (reductions in doses or use of alternative regimens), worsens the risk of toxic effects related to drugs, or limits the maintenance of treatment.…”

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confidence: 99%

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“Post-renal acute kidney injury in patients with cancer: Clinical presentation and kidney and patient outcomes”

Sousa

Reis

Ferreira

et al. 2023

Journal of Onco-Nephrology

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Background: Post-renal acute kidney injury (PR–AKI) is frequent in patients with cancer requiring emergent intervention. With our study we aimed to describe the clinical features and prognostic factors for kidney and overall survival (OS) in cancer patients with PR–AKI. Methods: This is a single-center retrospective study that included 306 cancer patients with PR–AKI admitted from January 2011 to December 2021. Previous kidney function, AKI episode, and progression to end-stage kidney disease (ESKD) were compared. Kaplan Meier and Cox proportional regression methods were used for survival analyses. Results: The most frequent type of malignancy was the prostate (52, 17%) followed by the uterus (50, 16.3%). The mean baseline eGFR was 62 ml/min/1.73 m2. AKI stage 3 was present in 157 patients (51.3%) and renal replacement therapy (RRT) was performed in 19 patients (6%). At discharge, 197 patients (64.4%) had a quick recovery, and during follow-up 8 (2.6%) patients progressed to ESKD. The risk factors associated with ESKD were previous decreased kidney function (eGFR<30 ml min 1.73m2) (HR 33.275, [95% CI, 3.997–277.002], p = 0.001); glomerular disease, (HR 8.353, [95%CI, 1.022–68.279], p=0.048); concomitant prerenal AKI (HR 5.670, [95% CI, 1.143–28.131], p = 0.034); and need of RRT (HR 19.519, [95% CI, 4.871–78.215], p < 0.001). Median OS was 6 months (IQR 1–24 months). We found differences in the global survival over 60 months, with longtime survivors including patients with Bricker (42.6% vs16.4%) and genito-urinary cancer (27.6% vs 11.7%). Gastric cancer (HR 2.943, [95%CI, 1.837–4.714], p<0.001), metastatic disease (HR 1.913, [95%CI, 1.464–2.499], p < 0.001), and direct tumoral invasion (HR 1.519, [95%CI, 1.115–2.070], p = 0.008) were related with a decreased survival. Conclusions: Gastric cancer, metastatic disease, and direct tumoral invasion were predictors of short survival. The main predictors of evolution to ESKD were previous kidney function, concomitant glomerular disease, and the need for RT.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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“Post-renal acute kidney injury in patients with cancer: Clinical presentation and kidney and patient outcomes”

Sousa

Reis

Ferreira

et al. 2023

Journal of Onco-Nephrology

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“…Of these, 468 were excluded by title and abstract screening, and a further 189 were excluded after full‐text assessment. Of the studies screened, 82 met the study criteria and were included in this review 4–85 . Figure 1 illustrates the process.…”

Section: Resultsmentioning

confidence: 99%

Malignant upper urinary tract obstruction in cancer patients: A systematic review

Shah,

Blest,

Blackmur

et al. 2024

BJUI Compass

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ObjectiveTo systematically summarise the current clinical evidence for de novo malignant upper urinary tract obstruction treatment with a focus on standards of reporting, patient outcomes and future research needs.MethodsThis review protocol was published via PROSPERO (CRD42022341588). OVID MEDLINE (R), EMBASE, Cochrane Central Register of Controlled Trials—CENTRAL were searched up to June 2022 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐analyses. Prospective and retrospective studies were included.ResultsOf 941 articles identified, 82 with 8796 patients were eligible for inclusion.Most studies in the published literature are retrospective and investigate heterogenous malignancies. Percutaneous nephrostomy and ureteric stenting are the most studied interventions. Few studies describe the outcomes from no intervention or investigate patient perspectives. Overall reported median survival after intervention was around 11.7 months. A lack of standardised reporting of outcomes was evident.ConclusionsMalignant upper urinary tract obstruction is an important clinical condition affecting patients globally. Overall survival after intervention appears poor however the current evidence base has significant limitations due to studies of low methodological quality and the lack of a standardised framework for reporting outcomes.We have provided a pragmatic framework for future studies based on the review to ensure a uniform methodology is utilised moving forward.

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“…Garg ve arkadaşları obstrüktif üropati gelişen 30 hastadan oluşan serilerinde perkütan nefrostomi sonrası 18 hastanın renal fonksiyonlarında iyileşme olduğunu ve iyileşme sonrası bu hastaların definitif tedavilerini tamamladıklarını bildirmişlerdir (24). Noegroho ve arkadaşları obstrüktif üropati gelişen serviks kanseri hastalarında yaptığı çalışmada da perkütan nefrostominin komplikasyonları önlemede etkili olduğunu bildirmişlerdir (25). Çalışmamızda 66 (%40,2) hastaya onkolojik nedenlerden perkütan nefrostomi takıldı.…”

Section: Discussionunclassified

Üroloji pratiğinde acil perkütan nefrostominin yeri; tek merkez deneyimi

et al. 2022

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Amaç: Bu çalışmada perkütan nefrostominin üroloji pratiğindeki önemini değerlendirmeyi amaçladık.Gereç ve Yöntemler: Ocak 2014 ile Ocak 2021 yılları arasında üroloji kliniğinde perkütan nefrostomi takılan hastaların kayıtları retrospektif olarak incelendi. Pyonefroz ve/veya böbrek fonksiyon testi yüksekliği tespit edilen ve acil şartlarda ürologlar tarafından perkütan nefrostomi takılan hastalar çalışmaya dahil edildi. Hastaların yaşları, hastaneye başvuru nedenleri, hidronefroz derecesi, primer patolojileri, işlem sonrası komplikasyonlar ve işlem sonrası yapılan elektif tedavileri değerlendirildi.Bulgular: Çalışmaya dahil edilen 164 hastanın 98’i erkek ve 66’sı kadındı. Hastaların ortalama yaşı 47,45 (18-90) yıl idi. Hastaların 120’sine tek taraflı, 44’üne ise bilateral olmak üzere toplam 208 renal üniteye perkütan nefrostomi katateri takıldı. 208 renal ünitenin 192’sinde (%95,2) perkütan nefrostomi başarılı bir şekilde takılırken, 10 (%4,8) renal ünitede işlem başarısız oldu ve ek girişim gerekti. Hastaların %40,2’sine onkolojik nedenlerden, %59,8’ine ise onkolojik dışı nedenlerden perkütan nefrostomi kateteri takıldı. İşlem sonrası minör komplikasyonlardan en sık görüleni transfüzyon gerektirmeyen geçici hematüri (%3,2) olup, ateş (%2,4), işlem sonrası devam eden ağrı (%1,6), kateter tıkanması (%0,8) ve geçici idrar sızıntısı (%0,8) diğer minör komplikasyonlardı. Majör komplikasyonlardan ise en sık görüleni ise nefrostominin yerinden çıkması (%3,2) idi.Sonuç: Perkütan nefrostomi obstrüktif üropati, pyonefroz tedavisi ve üriner diversiyon amacıyla uygulanan, yüksek başarı oranına sahip, etkili ve güvenli bir yöntemdir. Son zamanlarda girişimsel radyologlar tarafından daha fazla uygulanıyor olsa da ürologlar tarafından da başarılı bir şekilde uygulanabilmektedir.

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Factors Affecting Survival Outcome After Percutaneous Nephrostomy as Palliative Urinary Diversion in Obstructive Uropathy due to Advance Cervical Cancer Patients

Abstract: a 5-year survival rate of 84.5% to 85.9% (Benard et al., 2017). Nevertheless, a large number of cervical cancer cases present at higher grades, due to inadequate screening, cultural practices, health-seeking behaviors,

Cited by 12 publications

References 27 publications

“Post-renal acute kidney injury in patients with cancer: Clinical presentation and kidney and patient outcomes”

“Post-renal acute kidney injury in patients with cancer: Clinical presentation and kidney and patient outcomes”

Malignant upper urinary tract obstruction in cancer patients: A systematic review

Üroloji pratiğinde acil perkütan nefrostominin yeri; tek merkez deneyimi

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