Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Effect of Hydronephrosis on Survival in Advanced Stage Cervical Cancer

  • Published : 2015.06.03
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Abstract

Background: Hydronephrosis is frequently encountered in advanced stage cervical cancers, and may be associated with mortality. In the present study, we aimed to demonstrate the effect of hydronephrosis on survival in patients with inoperable advanced stage cervical cancer. Materials and Methods: The study data were acquired by retrospective analysis of the patient records belonging to 165 women with FIGO (International Federation of Gynecology and Obstetrics) stage-IIIB or more advanced cervical cancer, which were not surgical candidates. Parameters including patient age, pathological diagnosis, disease stage, pelvic sidewall extension, presence of hydronephrosis and administration of chemoradiation were analyzed. Further, the effects of these variables on survival were assessed. P values less than 0.05 were considered statistically significant. Results: The distribution of the study patients according to disease stage was as follows: 131 (79.4%) had stage-IIIB, 18 (10.9%) had stage-IVB and 16 (% 9.7) patients had stage-IVA disease. Hydronephrosis was not evident in 91 (55.2%) of these patients, whereas 41 (24.8%) had unilateral and 33 (20%) patients had bilateral hydronephrosis. When compared to mean survival in patients who did not have hydronephrosis, survival was significantly shortened in patients who had bilateral and unilateral hydronephrosis (p<0.05). There was no significant survival difference between patients with unilateral and bilateral hydronephrosis (p>0.05). Although patient age, pathological type, pelvic involvement, and chemotherapy treatment rates were similar (p>0.05), radiotherapy requirement rate and disease stage were significantly different among the study groups (p<0.05). Conclusions: Hydronephrosis was found to be a significant predictor of poor survival in patients with advanced stage cervical cancer, irrespective of unilateral or bilateral involvement.While waiting for future studies with larger sample sizes, we believe that the FIGO stages in advanced cervical cancer could further be stratified into subgroups according to presence or absence of hydronephrosis.

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References

  1. Anon (2010). Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer: individual patient data meta-analysis. Cochrane Database Syst Rev, 1, 82-5.
  2. Benedet JL, Bender H, Jones H, et al (2000). FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. Int J Gynaecol Obstet, 70, 209-62. https://doi.org/10.1016/S0020-7292(00)90001-8
  3. Chao KS, Leung WM, Grigsby PW, et al (1998). The clinical implications of hydronephrosis and the level of ureteral obstruction in stage IIIB cervical cancer. Int J Radiat Oncol Biol Phys, 40, 1095-100. https://doi.org/10.1016/S0360-3016(97)00899-7
  4. Demirtas B (2013). Review of strategies in promoting attendance for cervical screening. Asian Pac J Cancer Prev, 14, 3263-7. https://doi.org/10.7314/APJCP.2013.14.5.3263
  5. Espey DK, Wu X-C, Swan J, et al (2007). Annual report to the nation on the status of cancer, 1975-2004, featuring cancer in American Indians and Alaska Natives. Cancer, 110, 2119-52. https://doi.org/10.1002/cncr.23044
  6. Greer BE, Koh W-J, Abu-Rustum NR, et al (2010). Cervical cancer. J National Compr Cancer Network, 8, 1388-416. https://doi.org/10.6004/jnccn.2010.0104
  7. Hancke K, Heilmann V, Straka P, et al (2008). Pretreatment staging of cervical cancer: is imaging better than palpation?: Role of CT and MRI in preoperative staging of cervical cancer: single institution results for 255 patients. Ann Sur Oncol, 15, 2856-61. https://doi.org/10.1245/s10434-008-0088-7
  8. Hricak H, Gatsonis C, Chi DS, et al (2005). Role of imaging in pretreatment evaluation of early invasive cervical cancer: results of the intergroup study American college of radiology imaging network 6651-gynecologic oncology group 183. J clin oncol, 23, 9329-37. https://doi.org/10.1200/JCO.2005.02.0354
  9. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  10. Lee SK and Jones HW (1994). Prognostic significance of ureteral obstruction in primary cervical cancer. Int J Gynaecol Obstet, 44, 59-65. https://doi.org/10.1016/0020-7292(94)90024-8
  11. Miller BA, Chu KC, Hankey BF and Ries LAG (2008). Cancer incidence and mortality patterns among specific Asian and Pacific Islander populations in the U.S. Cancer Causes Control, 19, 227-56. https://doi.org/10.1007/s10552-007-9088-3
  12. Mitchell DG, Snyder B, Coakley F, et al (2006). Early invasive cervical cancer: tumor delineation by magnetic resonance imaging, computed tomography, and clinical examination, verified by pathologic results, in the ACRIN 6651/GOG 183 Intergroup Study. J Clin Oncol, 24, 5687-94. https://doi.org/10.1200/JCO.2006.07.4799
  13. Nartthanarung A, Thanapprapasr K, Udomsubpayakul U and Thanapprapasr D (2014). Age and survival of cervical cancer patients with bone metastasis. Asian Pac J Cancer Prev, 15, 8401-4. https://doi.org/10.7314/APJCP.2014.15.19.8401
  14. Patel K, Foster NR, Kumar A, et al (2015). Hydronephrosis in patients with cervical cancer: an assessment of morbidity and survival. Support Care Cancer, 23, 1303-9. https://doi.org/10.1007/s00520-014-2482-y
  15. Pecorelli S (2009). Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet, 105, 103-4. https://doi.org/10.1016/j.ijgo.2009.02.012
  16. Pradhan TS, Duan H, Katsoulakis E, et al (2011). Hydronephrosis as a prognostic indicator of survival in advanced cervix cancer. Int J Gynecol Cancer, 21, 1091-6. https://doi.org/10.1097/IGC.0b013e31821cabc8
  17. Rose PG, Ali S, Whitney CW, et al (2010). Impact of hydronephrosis on outcome of stage IIIB cervical cancer patients with disease limited to the pelvis, treated with radiation and concurrent chemotherapy: a Gynecologic Oncology Group study. Gynecol Oncol, 117, 270-5. https://doi.org/10.1016/j.ygyno.2010.01.045
  18. Shirazi AS, Razi T, Cheraghi F, et al (2014). Diagnostic accuracy of magnetic resonance imaging versus clinical staging in cervical cancer. Asian Pac J Cancer Prev, 15, 5729-32. https://doi.org/10.7314/APJCP.2014.15.14.5729
  19. Wit EM, Horenblas S (2014). Urological complications after treatment of cervical cancer. Nat Rev Urol, 11, 110-7. https://doi.org/10.1038/nrurol.2013.323