Hydronephrosis as a Prognostic Indicator of Survival in Advanced Cervix Cancer

Pradhan, T.; Duan, Haiou; Katsoulakis, Evangelia; Salame, Ghadir; Lee, Yi-Chun; Abulafia, Ovadia

doi:10.1097/igc.0b013e31821cabc8

Cited by 45 publications

(31 citation statements)

References 8 publications

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“…Survival was significantly shorter in patients with hydronephrosis (Pradhan et al, 2011). Likewise, our present study also demonstrated that hydronephrosis was associated with less survival.…”

Section: Discussionsupporting

confidence: 71%

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Effect of Hydronephrosis on Survival in Advanced Stage Cervical Cancer

Goklu

Seçkin²,

Toğrul³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: Hydronephrosis is frequently encountered in advanced stage cervical cancers, and may be associated with mortality. In the present study, we aimed to demonstrate the effect of hydronephrosis on survival in patients with inoperable advanced stage cervical cancer. Materials and Methods: The study data were acquired by retrospective analysis of the patient records belonging to 165 women with FIGO (International Federation of Gynecology and Obstetrics) stage-IIIB or more advanced cervical cancer, which were not surgical candidates. Parameters including patient age, pathological diagnosis, disease stage, pelvic sidewall extension, presence of hydronephrosis and administration of chemoradiation were analyzed. Further, the effects of these variables on survival were assessed. P values less than 0.05 were considered statistically significant. Results: The distribution of the study patients according to disease stage was as follows: 131 (79.4%) had stage-IIIB, 18 (10.9%) had stage-IVB and 16 (% 9.7) patients had stage-IVA disease. Hydronephrosis was not evident in 91 (55.2%) of these patients, whereas 41 (24.8%) had unilateral and 33 (20%) patients had bilateral hydronephrosis. When compared to mean survival in patients who did not have hydronephrosis, survival was significantly shortened in patients who had bilateral and unilateral hydronephrosis (p < 0.05). There was no significant survival difference between patients with unilateral and bilateral hydronephrosis (p>0.05). Although patient age, pathological type, pelvic involvement, and chemotherapy treatment rates were similar (p>0.05), radiotherapy requirement rate and disease stage were significantly different among the study groups (p<0.05). Conclusions: Hydronephrosis was found to be a significant predictor of poor survival in patients with advanced stage cervical cancer, irrespective of unilateral or bilateral involvement.While waiting for future studies with larger sample sizes, we believe that the FIGO stages in advanced cervical cancer could further be stratified into subgroups according to presence or absence of hydronephrosis.

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Section: Discussionsupporting

confidence: 71%

“…Besides medical treatment, percutaneous nephrostomy and ureteral stent placement is commonly undertaken. However, these interventions have not proven useful in prolongation of survival (Lee and Jones 1994;Pradhan et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Effect of Hydronephrosis on Survival in Advanced Stage Cervical Cancer

Goklu

Seçkin²,

Toğrul³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…Because hydronephrosis occurred at varying times during patients’ course of disease, a landmark analysis was performed at various times to assess the prognostic impact of hydronephrosis in univariate and multivariate Cox proportional hazards models. The inclusion of variables in both the logistic regression models and the Cox proportional hazards models was based on precedent in the published literature [1–3]. Because of the variability in approaches to cancer surveillance, cancer status was not used in the multivariate Cox proportional hazards models, although cancer stage was.…”

Section: Methodsmentioning

confidence: 99%

“…Second, previous studies report that hydronephrosis predicts compromised survival. Pradhan and others described that among 197 cervical cancer patients, hydronephrosis was associated with a statistically significant doubling of the risk for death [3]. Other investigators have reported similar prognostic outcomes in both univariate and multivariate analyses, although not consistently so [1, 2].…”

mentioning

confidence: 99%

“…However, these studies are older, recounting a patient experience that might no longer be contemporaneous and relevant. These studies also focused exclusively on patients with stage III cancer, an approach which can be justified based on the fact that the FIGO staging of cervical cancer ascribes stage III disease to patients with tumor-related hydronephrosis [1–3]. Clearly, however, patients with cervical cancer can develop hydronephrosis later in their disease course, and those who develop hydronephrosis as a postcancer diagnosis complication also merit inclusion in prognostic studies.…”

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confidence: 99%

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Hydronephrosis in patients with cervical cancer: an assessment of morbidity and survival

Patel

Foster

Kumar

et al. 2014

Support Care Cancer

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Purpose Hydronephrosis is a frequently observed but understudied complication in patients with cervical cancer. To better characterize hydronephrosis in cervical cancer patients, the current study sought (1) to describe hydronephrosis-associated morbidity and (2) to analyze the prognostic effect of hydronephrosis in patients with a broad range of cancer stages over time. Methods The Mayo Clinic Tumor Registry was interrogated for all invasive cervical cancer patients seen at the Mayo Clinic from 2008 through 2013 in Rochester, Minnesota; these patients’ medical records were then reviewed in detail. Results Two hundred seventy-nine cervical cancer patients with a median age of 49 years and a range of cancer stages were included. Sixty-five patients (23 %) were diagnosed with hydronephrosis at some point during their disease course. In univariate analyses, hydronephrosis was associated with advanced cancer stage (p<0.0001), squamous histology (p=0.0079), and nonsurgical cancer treatment (p=0.0039). In multivariate analyses, stage and tumor histology were associated with hydronephrosis. All but one patient underwent stent placement or urinary diversion; hydronephrosis-related morbidity included pain, urinary tract infections, nausea and vomiting, renal failure, and urinary tract bleeding. In landmark univariate survival analyses, hydronephrosis was associated with worse survival at all time points. In landmark multivariate analyses (adjusted for patient age, stage, cancer treatment, and tumor histology), hydronephrosis was associated with a trend toward worse survival over time (hazard ratios ranged from 1.47 to 4.69). Conclusion Hydronephrosis in cervical cancer patients is associated with notable morbidity. It is also associated with trends toward worse survival—even if it occurs after the original cancer diagnosis.

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Obstruction Solutions for Kidneys and Urinary Bladder

Khai

2021

Interventional Radiology in Palliative Care

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Hydronephrosis as a Prognostic Indicator of Survival in Advanced Cervix Cancer

Abstract: Hydronephrosis is an independent poor prognostic indicator of survival in patients with advanced cervical cancer. Bilateral hydronephrosis compared to unilateral involvement confers a worse overall prognosis. Additional studies are needed to determine if FIGO staging should be amended.

Cited by 45 publications

References 8 publications

Effect of Hydronephrosis on Survival in Advanced Stage Cervical Cancer

Effect of Hydronephrosis on Survival in Advanced Stage Cervical Cancer

Hydronephrosis in patients with cervical cancer: an assessment of morbidity and survival

Obstruction Solutions for Kidneys and Urinary Bladder

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