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Palliation of obstructive nephropathy due to malignancy
K J Harrington1, H S Pandha, S A Kelly
1Department of Clinical Oncology, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK.
British Journal of Urology
|July 1, 1995
Summary
Percutaneous nephrostomy and ureteric stents can prolong survival in malignant obstructive uropathy, especially when further cancer treatment is available. Patients unlikely to benefit should not undergo this intervention.
Area of Science:
- Urology
- Oncology
- Nephrology
Background:
- Malignant obstructive uropathy presents a significant challenge in cancer care.
- Urinary diversion via percutaneous nephrostomy and ureteric stents is a common intervention.
Purpose of the Study:
- To evaluate the outcomes of percutaneous nephrostomy and J-J ureteric stents in patients with malignant obstructive uropathy.
- To identify patient subgroups who benefit most from urinary diversion.
Main Methods:
- Prospective study of 42 patients with malignant obstructive uropathy.
- Urinary diversion followed by active cancer treatment where appropriate.
Main Results:
- Median survival was 133 days; 40% survived over 6 months.
- Patients with available therapeutic options for malignancy showed better outcomes.
- Complications included infection (16%), sepsis (6%), urine leak (13%), and renal failure in 21%.
Conclusions:
- Urinary diversion can offer prolonged survival in malignant obstructive uropathy.
- Patients with available cancer treatment options are most likely to benefit.
- Intervention should be carefully considered for patients with limited therapeutic options.