Evaluation of the outcome of percutaneous nephrostomy in patients with carcinoma cervix with malignant obstructive ropathy in a tertiary care hospital of northeast India: A Retrospective Study
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 1, Pages 5232-5237
AbstractMore than 70% cases of cervical cancer present in advanced stages of the disease, which are linked to a poor prognosis and significant fatality rates. Since many of them arrive with uremia due to obstructive uropathy, it is challenging to provide a conclusive course of treatment. Percutaneous nephrostomy (PCN) recommendations for patients with advanced cervical carcinoma are not well defined. The results of PCN are unpredictable in terms of recovery of renal function, quality of life, and benefits attained to administer the subsequent palliative care. Thus the aim of present study is to determine the outcome of PCN in cervical cancer patients presented with obstructive nephropathy secondary to malignant ureteral obstruction.
Material and methods: 72 patients of cervical cancer with obstructive uropathy and deranged renal functions were retrospectively evaluated for the role of PCN in their management conducted at Urology Unit, Department of General Surgery, Government Medical College, in collaboration with Regional cancer Centre (RCC), Agartala.
Results: PCN was done in 72 patients of advanced cervical cancer. 60 (83%) patients presented primarily with advanced cervical carcinoma and obstructive uropathy. 12 (16.6%) were already treated. Symptomatic improvement and significant fall of mean serum creatinine value from 7.7 mg% to 0.8 mg% over a period of 1-3 weeks was noted post PCN. Out of 60 patient with primary untreated advanced disease, curative treatment was possible in 12, palliative radiotherapy/chemo-therapy in 36 and only symptomatic treatment in 12 cases, after obstructive uropathy was managed with PCN insertion. PCN was done to prevent permanent kidney damage in them.
Conclusion: Despite certain unavoidable, but controllable, challenges, PCN is a straightforward and secure approach. One of the main advantages was that patients may receive either curative/palliative radiation or chemotherapy. Therefore, it is appropriate to try PCN in carefully chosen cervical cancer patients
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