Survival and quality of life after percutaneous nephrostomy for malignant ureteric obstruction in patients with terminal cervical cancer

Abstract

We describe 24 consecutive patients with cervical cancer stage III or IV who received palliative urinary diversion by percutaneous nephrostomy. All patients had proven malignant ureteric obstruction, uremia and failed ureteric stenting. 11 of 17 patients with extensive primary cancer and local lymph node involvement had an acceptable quality of life for 2 or more months while the mean survival was 5.6 months. Patients with disseminated metastasizing cancer were not satisfactorily served by nephrostomy.

The role of percutaneous nephrostomy in malignant ureteric obstruction

“…This retrospective study revealed that in this cohort of patients, predominantly locally advancing pelvic malignancies gave 6,7 months. These series, however, included patients with benign ureteric obstruction 6 and gynaecological malignancy, 5,7 which we suggest perform more favourably than other pelvic malignancies.…”

Outcome of palliative urinary diversion in the treatment of advanced malignancies

“…18 Conversely, patients with cervical carcinoma who had disseminated metastasis did poorly. 14 The majority of our patients had disseminated disease at the time of diversion. In patients with pelvic tumors, the performance status was significantly better in those with locally advanced (including lymph node metastasis) disease compared with those with disseminated disease (P ϭ 0.03); however, no statistically significant survival benefit was noted.…”

“…In a few studies on palliative urinary diversion in patients with advanced malignancies, the impact on quality of life after diversion has been addressed. 5,13,14 Most of these studies were conducted prior to the routine use of endoscopic diversion. The assessment of quality of life is difficult, and different arbitrary definitions have been used.…”

Subcutaneous Nephrovesical and Nephrocutaneous Bypass

“…The nephrostomy catheter can be inserted into the dilated renal pelvis in local anesthesia [14] . Patients' acceptance of permanent nephrostomy is low.…”