Percutaneous nephrostomy in cervical cancer patients: a retrospective analysis

Abstract

Objectives: To evaluate the outcome of patients with cervical carcinoma submitted to percutaneous nephrostomy due to malignant ureteral obstruction. Material and Methods: Retrospective cohort study with data obtained from medical records of patients diagnosed with cervical carcinoma with renal dysfunction (AKIN = stage 2) undergoing PCN for malignant obstructive uropathy between January 2019 and December 2020 at a tertiary hospital in Recife, Brazil. Results: We evaluated 31 patients submitted to percutaneous nephrostomy. Median age was 50 years, and the majority of women were non-white with an elementary education. Twenty-one patients required hemodialysis before the procedure, and 61.9% of them recovered renal function after nephrostomy. Bleeding and nephrostomy tube displacement were the leading causes of complications in the first 30 days (69%). Median overall survival after the procedure was 8.7 months. Survival was significantly worse in patients with anemia, ECOG performance status = 2 (p=0.04), pre-nephrostomy dialysis (p=0.01), and not recovery of renal function after PCN. Conclusions: Performing urinary diversion through percutaneous nephrostomy seems to offer greater benefits in patients with better functionality. Given the morbidity and complications inherent to percutaneous nephrostomy, the profile of patients who benefit most from the procedure remains unclear. Referrals for the procedure must be individualized and consider the patient's desire, treatment perspectives, and functionality.

To study the survival outcomes of uncommon recurrences among patients with cervical cancer compared with loco-regional and nodal recurrences at a tertiary care center in North East India – Bridging the knowledge gap in the existing literature.

“…Local or pelvis recurrences are most common site of involvement in cervical cancer. Next most frequent sites of involvement by recurrent cervical carcinoma are solid organ of abdomen [3] , [9] , [10] . Similar findings were also seen in our study with local recurrence (46.6 %), nodal recurrence (21 %), liver (21 %) and bone (15 %) of cases.…”

“…Follow-up of treated patients is guided by clinical assessment with diagnostic imaging performed when there is a clinical suspicion of residual or recurrent disease, preferably targeted as per the patient’s complaints [6] , [7] , [8] , [9] . Histological confirmation is sought depending on disease-free interval.…”