Hydronephrosis and survival in cervical cancer patients: The role of urinary diversion
Objective: We aimed to assess the impact of urinary diversion on survival in patients with advanced cervical cancer (CC) and hydronephrosis. Additionally, we examined the influence of other patient factors and urinary diversion type on survival. Methods: A retrospective study analyzed survival in ce...
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Elsevier
2025-02-01
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| Series: | Gynecologic Oncology Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S235257892400239X |
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| author | María Esther Garza-Montúfar Gibrán Domingo Carballo-Rosario Carlos Marcel García-Pérez |
| author_facet | María Esther Garza-Montúfar Gibrán Domingo Carballo-Rosario Carlos Marcel García-Pérez |
| author_sort | María Esther Garza-Montúfar |
| collection | DOAJ |
| description | Objective: We aimed to assess the impact of urinary diversion on survival in patients with advanced cervical cancer (CC) and hydronephrosis. Additionally, we examined the influence of other patient factors and urinary diversion type on survival. Methods: A retrospective study analyzed survival in cervical cancer (CC) patients with hydronephrosis treated at two Mexican hospitals from 2011 to 2023. Patient data, including demographics, clinical, and pathological characteristics, were collected. Urinary diversion details and complications were recorded. Survival analysis was performed using Kaplan-Meier method and Cox regression model to identify predictors of survival. Results: A total of 228 cervical cancer patients presenting with hydronephrosis were analyzed. Median follow-up was 9 months. The majority of patients were in stage IVA (44.3 %), with 66.7 % exhibiting bilateral renal involvement. Urinary diversion was performed in 192 patients (84.2 %). Median overall survival (OS) was 15.5 months. Multivariate analysis identified stage, disease course, oncologic treatment, laterality, performance status, and urinary diversion as independent prognostic factors for survival. In patients undergoing urinary diversion, bilateral renal involvement (HR 2.0) and deteriorated performance status (HR 3.6) were risk factors for mortality. Neither the laterality (unilateral or bilateral) nor the type of diversion significantly affected overall survival. Conclusions: Survival in CC patients with hydronephrosis is influenced by factors such as: bilateral involvement, performance status, clinical stage, course and treatment of the underlying malignancy and urinary diversion. Urinary diversion improves survival, regardless of the specific diversion type or whether the diversion is unilateral or bilateral. |
| format | Article |
| id | doaj-art-3a28c5ef12bf447a8b7dea234df4372c |
| institution | DOAJ |
| issn | 2352-5789 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj-art-3a28c5ef12bf447a8b7dea234df4372c2025-08-20T02:43:29ZengElsevierGynecologic Oncology Reports2352-57892025-02-015710166010.1016/j.gore.2024.101660Hydronephrosis and survival in cervical cancer patients: The role of urinary diversionMaría Esther Garza-Montúfar0Gibrán Domingo Carballo-Rosario1Carlos Marcel García-Pérez2Urology Department, Instituto Mexicano del Seguro Social, Hospital General de Zona N° 33, Monterrey, Nuevo León, Mexico; Corresponding author at: Av. Félix U Gómez S/N, Col. Centro, Monterrey, Nuevo León, CP 64010, Mexico.Urology Department, Instituto Mexicano del Seguro Social, Hospital General de Zona N° 33, Monterrey, Nuevo León, MexicoUrology Department, Instituto Mexicano del Seguro Social, Unidad de Medicina de Alta Especialidad N° 25, Monterrey, Nuevo León, MexicoObjective: We aimed to assess the impact of urinary diversion on survival in patients with advanced cervical cancer (CC) and hydronephrosis. Additionally, we examined the influence of other patient factors and urinary diversion type on survival. Methods: A retrospective study analyzed survival in cervical cancer (CC) patients with hydronephrosis treated at two Mexican hospitals from 2011 to 2023. Patient data, including demographics, clinical, and pathological characteristics, were collected. Urinary diversion details and complications were recorded. Survival analysis was performed using Kaplan-Meier method and Cox regression model to identify predictors of survival. Results: A total of 228 cervical cancer patients presenting with hydronephrosis were analyzed. Median follow-up was 9 months. The majority of patients were in stage IVA (44.3 %), with 66.7 % exhibiting bilateral renal involvement. Urinary diversion was performed in 192 patients (84.2 %). Median overall survival (OS) was 15.5 months. Multivariate analysis identified stage, disease course, oncologic treatment, laterality, performance status, and urinary diversion as independent prognostic factors for survival. In patients undergoing urinary diversion, bilateral renal involvement (HR 2.0) and deteriorated performance status (HR 3.6) were risk factors for mortality. Neither the laterality (unilateral or bilateral) nor the type of diversion significantly affected overall survival. Conclusions: Survival in CC patients with hydronephrosis is influenced by factors such as: bilateral involvement, performance status, clinical stage, course and treatment of the underlying malignancy and urinary diversion. Urinary diversion improves survival, regardless of the specific diversion type or whether the diversion is unilateral or bilateral.http://www.sciencedirect.com/science/article/pii/S235257892400239XHydronephrosisUterine cervical cancerUrinary diversionSurvival analysisUreteral obstruction |
| spellingShingle | María Esther Garza-Montúfar Gibrán Domingo Carballo-Rosario Carlos Marcel García-Pérez Hydronephrosis and survival in cervical cancer patients: The role of urinary diversion Gynecologic Oncology Reports Hydronephrosis Uterine cervical cancer Urinary diversion Survival analysis Ureteral obstruction |
| title | Hydronephrosis and survival in cervical cancer patients: The role of urinary diversion |
| title_full | Hydronephrosis and survival in cervical cancer patients: The role of urinary diversion |
| title_fullStr | Hydronephrosis and survival in cervical cancer patients: The role of urinary diversion |
| title_full_unstemmed | Hydronephrosis and survival in cervical cancer patients: The role of urinary diversion |
| title_short | Hydronephrosis and survival in cervical cancer patients: The role of urinary diversion |
| title_sort | hydronephrosis and survival in cervical cancer patients the role of urinary diversion |
| topic | Hydronephrosis Uterine cervical cancer Urinary diversion Survival analysis Ureteral obstruction |
| url | http://www.sciencedirect.com/science/article/pii/S235257892400239X |
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