Renal function and urological complications after radical hysterectomy with postoperative radiotherapy and platinum-based chemotherapy for cervical cancer.

Autor:	Okadome M; Gynecology Service, National Kyushu Cancer Center, Fukuoka., Saito T; Gynecology Service, National Kyushu Cancer Center, Fukuoka., Kitade S; Gynecology Service, National Kyushu Cancer Center, Fukuoka., Ariyoshi K; Gynecology Service, National Kyushu Cancer Center, Fukuoka., Shimamoto K; Gynecology Service, National Kyushu Cancer Center, Fukuoka., Kawano H; Department of Surgery, National Oita Medical Center, Oita., Minami K; Department of Surgery, National Kyushu Cancer Center, Fukuoka., Nakamura M; Department of Urology, National Kyushu Cancer Center., Shimokawa M; Clinical Research Institute, National Kyushu Cancer Center., Okushima K; Department of Diagnostic Imaging and Nuclear Medicine, National Kyushu Cancer Center., Kubo Y; Department of Diagnostic Imaging and Nuclear Medicine, National Kyushu Cancer Center., Kunitake N; Department of Radiation Oncology, National Kyushu Cancer Center, Fukuoka, Japan.
Jazyk:	angličtina
Zdroj:	Japanese journal of clinical oncology [Jpn J Clin Oncol] 2018 Feb 01; Vol. 48 (2), pp. 115-123.
DOI:	10.1093/jjco/hyx160
Abstrakt:	Background: We aimed to clarify renal functional changes long term and serious urological complications in women with cervical cancer who undergo radical hysterectomy followed by pelvic radiotherapy and/or platinum-based chemotherapy to treat the initial disease. Methods: Data on 380 women who underwent radical hysterectomy at the National Kyushu Cancer Center from January 1997 to December 2013 were reviewed. Main outcome measures were the estimated glomerular filtration rate (eGFR) and monitored abnormal urological findings. Results: Postoperative eGFR was significantly lower than preoperative eGFR in 179 women with surgery alone and in 201 women with additional pelvic radiotherapy and/or chemotherapy (both P < 0.01). Two types of univariate analyses for eGFR reduction in women after treatment showed that older age, advanced stage, pelvic radiotherapy, and platinum-based chemotherapy were significant variables on both analyses. Two types of multivariate analyses showed that platinum-based chemotherapy or pelvic radiotherapy were associated with impaired renal function (odds ratio 1.96, 95% confidence interval 1.08-3.54 and odds ratio 2.85, 95% confidence interval 1.12-7.24, for the respective analyses). There was a higher rate of bladder wall thickening in women with pelvic radiotherapy had than those without it (17.4% vs. 2.7%, P < 0.01). One serious urological complication (intraperitoneal rupture of the bladder) occurred among women who underwent pelvic radiotherapy (0.6% vs. 0%). Conclusions: Surgeons should be aware that eGFR is reduced after platinum-based chemotherapy and/or postoperative pelvic radiotherapy. Serious and life-threatening urological complications are rare, but surgeons should be aware of the possibility during the long follow-up. (© The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu