Prognostic significance of ureteral obstruction in primary cervical cancer.

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.