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

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).

Download Full-text

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

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.19609 ◽

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.

Download Full-text

Pre-hysterectomy cone biopsy is able to predict response in locally advanced cervical cancer patients submitted to neo-adjuvant chemoradiation

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2013.06.003 ◽

2013 ◽

Vol 39 (9) ◽

pp. 1025-1029 ◽

Cited By ~ 4

Author(s):

F. Fanfani ◽

A. Fagotti ◽

M.L. Gagliardi ◽

G. Ferrandina ◽

G. Monterossi ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Patients ◽

Locally Advanced ◽

Advanced Cervical Cancer ◽

Adjuvant Chemoradiation ◽

Locally Advanced Cervical Cancer ◽

Cone Biopsy

Download Full-text

A phase I pharmacokinetic and safety study of cabazitaxel in adult cancer patients with normal and impaired renal function

Cancer Chemotherapy and Pharmacology ◽

10.1007/s00280-016-3175-7 ◽

2016 ◽

Vol 78 (6) ◽

pp. 1185-1197 ◽

Cited By ~ 1

Author(s):

Analía Azaro ◽

Jordi Rodón ◽

Jean-Pascal Machiels ◽

Sylvie Rottey ◽

Silvia Damian ◽

...

Keyword(s):

Renal Function ◽

Phase I ◽

Cancer Patients ◽

Impaired Renal Function ◽

Safety Study

Download Full-text

Efficacy and safety evaluation of HLX10 (a recombinant humanized anti-PD-1 monoclonal antibody) combined with albumin-bound paclitaxel in patients with advanced cervical cancer who have progressive disease or intolerable toxicity after first-line standard chemotherapy: A single-arm, open-label, phase 2 study.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e17510 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e17510-e17510

Author(s):

Lingying Wu ◽

Xiumin Li ◽

Jing Wang ◽

Lijing Zhu ◽

Ruifang An ◽

...

Keyword(s):

Cervical Cancer ◽

Adverse Events ◽

Cancer Patients ◽

Advanced Cervical Cancer ◽

Phase 2 ◽

First Line ◽

Standard Chemotherapy ◽

Open Label ◽

Phase 2 Study ◽

Line Standard

e17510 Background: Limited effective treatments are available for advanced cervical cancer patients who progress after first-line chemotherapy. Historic data indicate PD-1 antibodies have significant activity in advanced cervical cancer patients. This study was designed to determine the efficacy and safety of HLX10 (a recombinant humanized anti-PD-1 monoclonal antibody) plus albumin-bound paclitaxel in patients with advanced cervical cancer who have progressed on or are intolerant to first-line standard chemotherapy. Methods: This is an ongoing single-arm, open-label, multicenter, two-stage phase 2 study (NCT04150575). 143 eligible patients aged between 18 and 75, with histologically or cytologically diagnosed cervical cancer and positive PD-L1 expression (combined positive score [CPS] ≥1) were planned to be enrolled and given intravenous infusion of HLX10 (4.5 mg/kg) plus albumin-bound paclitaxel (260 mg/m2) every 3 weeks. Stage one (N = 20) was a safety run-in and preliminary efficacy exploration study with primary endpoints of adverse events, serious adverse events and objective response rate (ORR, assessed by IRRC per RECIST v1.1). In this stage, after all patients completed two tumor evaluations (every 6 weeks), a safety evaluation and a preliminary evaluation of anti-tumor efficacy were conducted to determine whether to proceed to the second stage (N = 123). Stage two is a single-arm, open-label, multicenter, phase 2 study with primary endpoint of ORR assessed by IRRC per RECIST v1.1. Results: Here we report the stage one results (safety and preliminary efficacy) of HLX10 in advanced cervical cancer patients. By cut-off date Oct 14, 2020, 21 eligible patients with median age of 50 (range: 31–65) and average CPS of 39.33 were enrolled; the median follow-up duration was 4.34 months. 71.4% patients had ECOG PS 1. The ORR assessed by IRRC and investigators were 52.4% (95% CI: 29.8%, 74.3%) and 42.9% (95% CI: 21.8%, 66.0%), respectively. The most common grade 3 or worse treatment-emergent adverse events (TEAEs) were decreased neutrophil counts (n = 7, 33.3%), decreased white blood cell count (n = 6, 28.6%) and anemia (n = 4, 19.0%). No TEAEs leading to drug discontinuation were observed. One death (multiple organ dysfunction syndrome) possibly related to treatment was reported. Conclusions: Stage one results demonstrated a manageable safety profile and encouraging efficacy (ORR 52.4%) of HLX10 plus albumin-bound paclitaxel in advanced cervical cancer patients who have progressive disease or intolerable toxicity to first-line standard chemotherapy, representing a novel potential treatment option that warranted further investigation. Clinical trial information: NCT04150575.

Download Full-text

Oncothermia in HIV-Positive and -Negative Locally Advanced Cervical Cancer Patients in South Africa

Conference Papers in Medicine ◽

10.1155/2013/293968 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3

Author(s):

Carrie A. Strauss ◽

Jeffrey A. Kotzen ◽

Ans Baeyens ◽

Irma Maré

Keyword(s):

South Africa ◽

Cervical Cancer ◽

Cancer Patients ◽

Standard Treatment ◽

Locally Advanced ◽

External Beam Radiation ◽

Hiv Positive ◽

Advanced Cervical Cancer ◽

Treatment Toxicity ◽

Locally Advanced Cervical Cancer

Aim. Investigate the clinical, economic, and cellular effects of the addition of oncothermia to standard treatment for HIV-positive and -negative locally advanced cervical cancer patients in public healthcare in South Africa. Objectives. Evaluate the effect that the addition of oncothermia has on local disease control, progression-free survival, overall survival at 2 years, treatment toxicity, quality of life, economic impact, and HIV status of participants. Radiobiology investigations will evaluate thermoradiosensitivity and the molecular markers for thermoradiosensitivity. Methodology. Phase III randomised clinical trial involving 236 HIV-negative and -positive stage IIb-III locally advanced cervical cancer patients. Treatment includes cisplatin, external beam radiation, and brachytherapy. The study group will receive oncothermia treatments. Participants will be monitored for two years after completion of treatment. Hypothesis. The addition of oncothermia to standard treatment protocols will result in improved clinical response without increasing treatment toxicity in HIV-positive patients or raising healthcare costs.

Download Full-text

Cervical cancer: Renal complications and survival after percutaneous nephrostomy

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.62.03.255 ◽

2016 ◽

Vol 62 (3) ◽

pp. 255-261 ◽

Cited By ~ 2

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.

Download Full-text