Hydronephrosis in advanced ovarian carcinoma

In a consecutive series of 232 patients with ovarian carcinoma, (FIGO IIB-IV), receiving combination chemotherapy, 52 patients (22%) presented with (early, 69%) or developed (late, 31%) hydronephrosis diagnosed by intravenous pyelography or abdominal ultrasound scan. Unilateral hydronephrosis was seen in 77%, bilateral in 23%. Patients with hydronephrosis were characterized by stage IIIB-IV (67%), and primary residual tumor size greater than 2 cm (81%). Nine patients (17%) developed concomittantly impaired renal function diagnosed by a rise in se-creatinine and/or a decrease in 51Cr-EDTA clearance. No difference in survival was seen in patients with early or late hydronephrosis, nor with uni- or bilateral hydronephrosis, but patients with hydronephrosis at the start of chemotherapy lived significantly shorter than those without hydronephrosis, P less than .05. In conclusion, hydronephrosis is a common complication to advanced ovarian carcinoma, and the presence of this complication at the start of chemotherapy has a negative impact on survival.