Palliative percutaneous nephrostomy in recurrent cervical cancer: Retrospective analysis of 50 consecutive cases

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19609-19609
Author(s):  
C. S. Pinto ◽  
I. A. Small ◽  
C. G. Ferreira ◽  
R. Dienstmann
Keyword(s):  
Cervical Cancer ◽  
Palliative Care ◽  
Renal Failure ◽  
Renal Function ◽  
Median Survival ◽  
Locally Advanced ◽  
Public Health Problem ◽  
Percutaneous Nephrostomy ◽  
Lumbar Pain ◽  
Recurrent Cervical Cancer

19609 Background: Cervical cancer is a public health problem in Brazil, with annual incidence rates of 20 to 40 cases/ 100.000 women. Most patients with recurrent disease have local symptoms and develop renal failure. There are no clear guidelines to predict which patients in palliative care derive benefit from percutaneous nephrostomy (PN) in terms of survival and quality of life. This study aims to evaluate the outcome of patients with recurrent cervical cancer in palliative care submitted to PN and thereby identify those who can potentially benefit from this intervention. Methods: Retrospective chart review of all patients assisted in the Palliative Care Unit of Brazilian National Cancer Institute from January 2002 to October 2006 and submitted to PN. Results: Fifty patients received unilateral PN. Median age was 44 years (26 - 67). All patients were previously treated with radiotherapy with or without chemotherapy and brachytherapy. At relapse, 50 presented with locally advanced disease and 7 also had metastatic disease. Twenty-four patients (49%) had improvement of uremic symptoms and/ or lumbar pain after PN and seven (14%) in Performance Status (PS). Median creatinine levels before and after PN were 6.4 and 3.7 mg/dl, respectively (p < 0.05). Twenty-five patients (50%) had improvement in renal function. Until December 2006, 49 patients have died. Median overall survival after PN was 9.1 weeks (95% CI: 8.0 - 10.2). Median survival was 10 weeks (9.0 - 11.0) in 40 patients with baseline PS 1 - 3 and 1.7 weeks (0 - 3.7) in 10 patients with PS 4 (log rank, p = 0.04). Median survival in patients with and without improvement of renal function after PN was 10.7 weeks (8.6 - 12.8) and 8.1 weeks (4.8 - 11.5), respectively (log rank, p = 0.02). Twenty-nine patients (58%) died due to renal failure. Complications of PN were mainly urinary tract infection (n: 10), catheter loss (n: 9) and bleeding (n: 1). Conclusions: These data suggest that PN can be of clinical benefit for patients with recurrent cervical cancer and PS 1 to 3, but not PS 4. In fact, improvement of renal function after PN did prolong survival. Complications of PN are frequent and most patients still die in renal failure. However, our data indicate that carefully selected patients can derive benefit from this procedure. No significant financial relationships to disclose.

scholarly journals Effect of percutaneous nephrostomy in late stage cervical cancer’s survival with impaired renal function

2018 ◽  
Vol 24 (2) ◽  
pp. 49
Author(s):  
Imam Rasjidi Mashadi ◽  
Ali Gunawan ◽  
Christine Susanto
Keyword(s):  
Cervical Cancer ◽  
Renal Function ◽  
Cancer Patients ◽  
Median Survival ◽  
Medical Records ◽  
Impaired Renal Function ◽  
Percutaneous Nephrostomy ◽  
Advanced Cervical Cancer ◽  
Probability Of Survival ◽  
Consecutive Sampling

Objective: explore the association between percutaneous nephrostomy and survival of patients with advanced cervical cancer accompanied by renal impairment.Materials and Methods: Retrospective cohort, with 70 samples taken with consecutive sampling. The population was all advanced cervical cancer patients with impaired renal function (IIIB, IVA, IVB, recurrent) treated in RSUPNCM since January 1, 1998. Sample size was each 19 patients for percutaneous nephrostomy and conservative groups. Survival was measured from medical records of advanced cervical cancer patients with impaired renal function who were treated at RSUPNCM since January 1, 1998 until December 31, 2003. Percutaneous nephrostomy was measured from medical records of advanced cervical cancer patients with impaired renal function treated at RSUPNCM since 1 January 1998 until December 31, 2003.Results: Median survival of 44 respondents who underwent percutaneous nephrostomy was 203 days with probability of survival at 6 months 56.9% and 12 months by 31.1%. Median survival of 26 respondents who did not undergo percutaneous nephrostomy was 75 days with a chance of survival at 6 months 26.6% and 12 months 10%. There were significant differences between patients undergoing percutaneous nephrostomy and those without (p = 0.0470, α = 0.05).Conclusion: There was significant association between percutaneous nephrostomy and survival (p = 0.0470, α = 0.05).

scholarly journals Effect of percutaneous nephrostomy in late stage cervical cancer’s survival with impaired renal function

2017 ◽  
Vol 24 (2) ◽  
pp. 49
Author(s):  
Imam Rasjidi ◽  
Ali Gunawan ◽  
Christine Susanto
Keyword(s):  
Cervical Cancer ◽  
Renal Function ◽  
Cancer Patients ◽  
Median Survival ◽  
Medical Records ◽  
Impaired Renal Function ◽  
Percutaneous Nephrostomy ◽  
Advanced Cervical Cancer ◽  
Probability Of Survival ◽  
Consecutive Sampling

Objective: explore the association between percutaneous nephrostomy and survival of patients with advanced cervical cancer accompanied by renal impairment.Materials and Methods: Retrospective cohort, with 70 samples taken with consecutive sampling. The population was all advanced cervical cancer patients with impaired renal function (IIIB, IVA, IVB, recurrent) treated in RSUPNCM since January 1, 1998. Sample size was each 19 patients for percutaneous nephrostomy and conservative groups. Survival was measured from medical records of advanced cervical cancer patients with impaired renal function who were treated at RSUPNCM since January 1, 1998 until December 31, 2003. Percutaneous nephrostomy was measured from medical records of advanced cervical cancer patients with impaired renal function treated at RSUPNCM since 1 January 1998 until December 31, 2003.Results: Median survival of 44 respondents who underwent percutaneous nephrostomy was 203 days with probability of survival at 6 months 56.9% and 12 months by 31.1%. Median survival of 26 respondents who did not undergo percutaneous nephrostomy was 75 days with a chance of survival at 6 months 26.6% and 12 months 10%. There were significant differences between patients undergoing percutaneous nephrostomy and those without (p = 0.0470, α = 0.05).Conclusion: There was significant association between percutaneous nephrostomy and survival (p = 0.0470, α = 0.05).

SURGERY FOR RESIDUAL DISEASE AFTER RADIOTHERAPY IN LOCALLY ADVANCED CERVICAL CANCER

2019 ◽  
Vol 65 (5) ◽  
pp. 721-725
Author(s):  
Elmira Shakirova ◽  
Andrey Panov ◽  
Alevtina Akhmetzyanova ◽  
Aliya Gafiullina ◽  
L. Ibragimova ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Residual Disease ◽  
Locally Advanced ◽  
Residual Tumor ◽  
Advanced Cervical Cancer ◽  
Mri Imaging ◽  
Recurrent Cervical Cancer ◽  
Locally Advanced Cervical Cancer ◽  
Visible Effect ◽  
Adjuvant Hysterectomy

Aims: Chemoradiation (CRT) is the standard treatment for locally advanced cervical cancer (LACC). However part of the patients develop recurrence during the first year after treatment despite good visible effect at the first follow-up. The role of completion surgery after radiotherapy (RT) is still debated. A number of papers have showed that up to 60% of patients have residual tumor after CRT and RT. But such a surgery is not widely recommended because of increased morbidity of the treatment. The aim of this study was to assess the results of surgery after radiotherapy of LACC. Method: We retrospectively evaluated data on 86 patients with cervical cancer IB - IIIB stages (mostly stage IIB) who underwent surgery in different modalities after CRT and RT with good clinical response in our department in 2015-2018. Results: When small asymptomatic residual disease was detected early after radiotherapy radical hysterectomy was feasible in most of the cases. Patients with clinical manifestation of recurrence had very poor prognosis. Surgery of recurrent cervical cancer sufficiently deteriorates quality of life, even if possible. Conclusion: Thorough examination with adding MRI imaging after initial treatment of cervical cancer needed to identify patients who may benefit from adjuvant hysterectomy.

scholarly journals Cervical cancer: Renal complications and survival after percutaneous nephrostomy

2016 ◽  
Vol 62 (3) ◽  
pp. 255-261 ◽  
Author(s):  
Alzira Carvalho Paula de Souza ◽  
Alfredo Nunes Souza ◽  
Rubens Kirsztajn ◽  
Gianna Mastroianni Kirsztajn
Keyword(s):  
Blood Pressure ◽  
Cervical Cancer ◽  
Renal Function ◽  
Percutaneous Nephrostomy ◽  
Cross Sectional Study ◽  
Obstructive Nephropathy ◽  
Cross Sectional ◽  
Low Blood Pressure ◽  
Northern Brazil

SUMMARY Introduction: Obstructive nephropathy is a frequent complication in the course of advanced cervical cancer (CC), and ultrasonography-guided percutaneous nephrostomy (PCN) is a well established technique for fast ureteral desobstruction. Objective: To identify possible factors related to the survival and quality of life of patients with advanced CC presenting acute urinary obstructive complications that after desobstruction by PCN recovered urinary flux and renal function. Method: This is an analytical, descriptive, cross-sectional study that included 45 patients with CC who underwent PCN and were divided into 2 groups: “death” (DG) and “survival” (SG), in a public hospital that is reference for oncologic diseases in Northern Brazil. Results: The mean serum creatinine of the patients preceding PCN was >10 mg/dL, and after PCN <2 mg/dL. The cutoffs of 8.7 g/dL for Hb (p=0.0241) and 27% for Ht (p=0.0065) indicated the values that better discriminate the outcomes of the groups. The presence of low blood pressure was statistically correlated (p=0.0037) to the outcome “death”. Changes in glomerular filtration rate (already reduced in all cases) were not associated to the levels of Hb/Ht or to the outcome “death” during the nephrological follow-up. Conclusion: PCN was responsible for the recovery of renal function in 61.7% of the patients, leading to interruption of renal replacement therapy (RRT) in all of those patients. Hb levels >8.7g/dL and Ht >27% were associated to longer survival, and the presence of low blood pressure during follow-up was associated with progression to death.

Intraoperative Electron Beam Radiotherapy during Radical Surgery for Locally Advanced and Recurrent Cervical Cancer

2001 ◽  
Vol 82 (3) ◽  
pp. 538-543 ◽  
Author(s):  
R. Martı´nez-Monge ◽  
M. Jurado ◽  
J.J. Aristu ◽  
M. Moreno ◽  
M. Cambeiro ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Electron Beam ◽  
Radical Surgery ◽  
Locally Advanced ◽  
Recurrent Cervical Cancer ◽  
Electron Beam Radiotherapy

Palliative percutaneous nephrostomy in 26 patients with recurrent cervical cancer

2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 8235-8235
Author(s):  
R. Dienstmann ◽  
C. Da Silva Pinto ◽  
M. Tutungi Pereira ◽  
I. Avila Small
Keyword(s):  
Cervical Cancer ◽  
Percutaneous Nephrostomy ◽  
Recurrent Cervical Cancer

Weekly Carboplatin and Docetaxel for Locally Advanced Primary and Recurrent Cervical Cancer: A Phase I Study

2002 ◽  
Vol 87 (1) ◽  
pp. 98-103 ◽  
Author(s):  
D.T. Rein ◽  
C.M. Kurbacher ◽  
M. Breidenbach ◽  
T. Schöndorf ◽  
T. Schmidt ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Phase I ◽  
Phase I Study ◽  
Locally Advanced ◽  
Recurrent Cervical Cancer

Value of Dual-Phase 2-Fluoro-2-Deoxy-d-Glucose Positron Emission Tomography in Cervical Cancer

2003 ◽  
Vol 21 (19) ◽  
pp. 3651-3658 ◽  
Author(s):  
Tzu-Chen Yen ◽  
Koon-Kwan Ng ◽  
Shih-Ya Ma ◽  
Hung-Hsueh Chou ◽  
Chien-Sheng Tsai ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Positron Emission Tomography ◽  
Fdg Pet ◽  
Characteristic Curve ◽  
Locally Advanced ◽  
Emission Tomography ◽  
Dual Phase ◽  
Recurrent Cervical Cancer ◽  
Metastatic Lesions ◽  
Positron Emission

Purpose: The role of positron emission tomography (PET) with fluorine-18–labeled fluoro-2-deoxy-d-glucose (FDG) in cervical cancer has not yet been well defined. We conducted a prospective study to investigate its efficacy in comparison with magnetic resonance imaging and/or computed tomography (MRI-CT). Materials and Methods: Patients with untreated locally advanced (35%) or recurrent (65%) cervical cancer were enrolled onto this study. In the first part of this study, 41 patients had a conventional FDG-PET (40 minutes after injection), and in the second part, 94 patients received dual-phase PET (at both 40 minutes and 3 hours after injection). The overall results of PET scans were compared with MRI-CT, and the two protocols of PET were also compared with each other. Lesion status was determined by pathology results or clinical follow-up. The receiver operating characteristic curve method with area under the curve (AUC) calculation was used to evaluate the discriminative power. Results: Overall (N = 135), FDG-PET was significantly superior to MRI-CT in identifying metastatic lesions (AUC, 0.971 v 0.879; P = .039), although the diagnostic accuracy was similar for local tumors. Dual-phase PET was also significantly better than the 40-minute PET (n = 94). The latter accurately recognized 70% of metastatic lesions and the former detected 90% (AUC, 0.943 v 0.951; P = .007). Dual-phase FDG-PET changed treatment of 29 patients (31%; upstaging 27% and downstaging 4%). Conclusion: This study shows that dual-phase FDG-PET is superior to conventional FDG-PET or MRI-CT in the evaluation of metastatic lesions in locally advanced or recurrent cervical cancer.

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