宫颈癌患者肾积水与生存：尿改道的作用。

IF 1.2 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports Pub Date : 2025-02-01 DOI:10.1016/j.gore.2024.101660

María Esther Garza-Montúfar , Gibrán Domingo Carballo-Rosario , Carlos Marcel García-Pérez

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引用次数: 0

摘要

目的：我们旨在评估尿分流对晚期宫颈癌（CC）合并肾积水患者生存的影响。此外，我们还检查了其他患者因素和尿分流类型对生存的影响。方法：回顾性分析2011年至2023年在墨西哥两家医院治疗的宫颈癌（CC）肾积水患者的生存率。收集患者资料，包括人口统计学、临床和病理特征。记录尿分流细节及并发症。生存分析采用Kaplan-Meier法和Cox回归模型确定生存预测因子。结果：对228例以肾积水为临床表现的宫颈癌患者进行了分析。中位随访为9个月。大多数患者为IVA期（44.3%），其中66.7%表现为双侧肾脏受累。192例（84.2%）患者行尿分流术。中位总生存期（OS）为15.5个月。多变量分析确定分期、病程、肿瘤治疗、侧边性、运动状态和尿分流是影响生存的独立预后因素。在尿改道患者中，双侧肾脏受累（HR 2.0）和运动状态恶化（HR 3.6）是死亡的危险因素。侧边性（单侧或双侧）和转移类型均未显著影响总生存率。结论：CC合并肾积水患者的生存受双侧受累、运动状态、临床分期、病程、潜在恶性肿瘤治疗及尿分流等因素的影响。尿改道提高了生存率，无论具体的改道类型或改道是单侧还是双侧。

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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 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.

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来源期刊

Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

183

审稿时长

41 days

期刊介绍： Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.