Hydronephrosis in patients with cervical cancer: an assessment of morbidity and survival
| Autor: | Sherri Longenbach, Jamie N. Bakkum-Gamez, Amanika Kumar, Megan Grudem, Michael G. Haddock, Nathan R. Foster, Sean C. Dowdy, Krishna Patel, Aminah Jatoi |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty Minnesota medicine.medical_treatment Uterine Cervical Neoplasms Hydronephrosis Urinary Diversion Article Young Adult medicine Humans In patient Young adult Survival analysis Aged Neoplasm Staging Aged 80 and over Cervical cancer business.industry Urinary diversion Cancer Middle Aged Prognosis medicine.disease Survival Analysis Surgery Oncology Multivariate Analysis Female Radiology business Complication |
| Zdroj: | Supportive Care in Cancer. 23:1303-1309 |
| ISSN: | 1433-7339 0941-4355 |
| DOI: | 10.1007/s00520-014-2482-y |
| Popis: | Hydronephrosis is a frequently observed but understudied complication in patients with cervical cancer. To better characterize hydronephrosis in cervical cancer patients, the current study sought (1) to describe hydronephrosis-associated morbidity and (2) to analyze the prognostic effect of hydronephrosis in patients with a broad range of cancer stages over time.The Mayo Clinic Tumor Registry was interrogated for all invasive cervical cancer patients seen at the Mayo Clinic from 2008 through 2013 in Rochester, Minnesota; these patients' medical records were then reviewed in detail.Two hundred seventy-nine cervical cancer patients with a median age of 49 years and a range of cancer stages were included. Sixty-five patients (23 %) were diagnosed with hydronephrosis at some point during their disease course. In univariate analyses, hydronephrosis was associated with advanced cancer stage (p 0.0001), squamous histology (p = 0.0079), and nonsurgical cancer treatment (p = 0.0039). In multivariate analyses, stage and tumor histology were associated with hydronephrosis. All but one patient underwent stent placement or urinary diversion; hydronephrosis-related morbidity included pain, urinary tract infections, nausea and vomiting, renal failure, and urinary tract bleeding. In landmark univariate survival analyses, hydronephrosis was associated with worse survival at all time points. In landmark multivariate analyses (adjusted for patient age, stage, cancer treatment, and tumor histology), hydronephrosis was associated with a trend toward worse survival over time (hazard ratios ranged from 1.47 to 4.69).Hydronephrosis in cervical cancer patients is associated with notable morbidity. It is also associated with trends toward worse survival-even if it occurs after the original cancer diagnosis. |
| Databáze: | OpenAIRE |
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