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Prognostic significance of ureteral obstruction in primary cervical cancer
1Gynecological Oncology Unit, Vanderbilt University Hospital, Nashville, Tennessee.
Objectives:
To evaluate the prognostic significance of ureteral obstruction in women with cervical cancer and the result of aggressive urinary diversion.
Methods:
The clinical history and X-rays of 52 women with Stage III and IV cervical cancer seen at Vanderbilt University between 1981 and 1991 were retrospectively reviewed.
Results:
Twenty-nine (55.8%) of these patients had unilateral [15] or bilateral [14] ureteral obstruction. There was no statistically significant difference in the survival of patients whether or not ureteral obstruction was present. Ten of fourteen women with bilateral ureteral obstruction and 4 of the 15 patients with unilateral obstruction underwent urinary diversion by percutaneous nephrostomy [9] or retrograde ureteral catheterization [5]. Complications were few. Although patients who underwent urinary diversion had somewhat better survival, it was not statistically significant.
Conclusions:
Some patients with ureteral obstruction due to advanced cervical cancer can be salvaged by prompt, aggressive urinary diversion, but large trials are needed to validate this approach.