Effect of Hydronephrosis on Survival in Advanced Stage Cervical Cancer


Background: Hydronephrosis is frequently encountered in advanced stage cervical cancers, and may beassociated with mortality. In the present study, we aimed to demonstrate the effect of hydronephrosis on survivalin patients with inoperable advanced stage cervical cancer. Materials and
Methods: The study data were acquiredby retrospective analysis of the patient records belonging to 165 women with FIGO (International Federation ofGynecology and Obstetrics) stage-IIIB or more advanced cervical cancer, which were not surgical candidates.Parameters including patient age, pathological diagnosis, disease stage, pelvic sidewall extension, presence ofhydronephrosis and administration of chemoradiation were analyzed. Further, the effects of these variables onsurvival were assessed. P values less than 0.05 were considered statistically significant.
Results: The distributionof the study patients according to disease stage was as follows: 131 (79.4%) had stage-IIIB, 18 (10.9%) hadstage-IVB and 16 (% 9.7) patients had stage-IVA disease. Hydronephrosis was not evident in 91 (55.2%) ofthese patients, whereas 41 (24.8%) had unilateral and 33 (20%) patients had bilateral hydronephrosis. Whencompared to mean survival in patients who did not have hydronephrosis, survival was significantly shortened inpatients who had bilateral and unilateral hydronephrosis (p < 0.05). There was no significant survival differencebetween patients with unilateral and bilateral hydronephrosis (p>0.05). Although patient age, pathological type,pelvic involvement, and chemotherapy treatment rates were similar (p>0.05), radiotherapy requirement rate anddisease stage were significantly different among the study groups (p<0.05).
Conclusions: Hydronephrosis wasfound to be a significant predictor of poor survival in patients with advanced stage cervical cancer, irrespectiveof unilateral or bilateral involvement.While waiting for future studies with larger sample sizes, we believe thatthe FIGO stages in advanced cervical cancer could further be stratified into subgroups according to presenceor absence of hydronephrosis.