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Supportive Care in Cancer

, Volume 23, Issue 5, pp 1303–1309 | Cite as

Hydronephrosis in patients with cervical cancer: an assessment of morbidity and survival

  • Krishna Patel
  • Nathan R. Foster
  • Amanika Kumar
  • Megan Grudem
  • Sherri Longenbach
  • Jamie Bakkum-Gamez
  • Michael Haddock
  • Sean Dowdy
  • Aminah JatoiEmail author
Original Article

Abstract

Purpose

Hydronephrosis is a frequently observed but understudied complication in patients with cervical cancer. To better characterize hydronephrosis in cervical cancer patients, the current study sought (1) to describe hydronephrosis-associated morbidity and (2) to analyze the prognostic effect of hydronephrosis in patients with a broad range of cancer stages over time.

Methods

The Mayo Clinic Tumor Registry was interrogated for all invasive cervical cancer patients seen at the Mayo Clinic from 2008 through 2013 in Rochester, Minnesota; these patients’ medical records were then reviewed in detail.

Results

Two hundred seventy-nine cervical cancer patients with a median age of 49 years and a range of cancer stages were included. Sixty-five patients (23 %) were diagnosed with hydronephrosis at some point during their disease course. In univariate analyses, hydronephrosis was associated with advanced cancer stage (p < 0.0001), squamous histology (p = 0.0079), and nonsurgical cancer treatment (p = 0.0039). In multivariate analyses, stage and tumor histology were associated with hydronephrosis. All but one patient underwent stent placement or urinary diversion; hydronephrosis-related morbidity included pain, urinary tract infections, nausea and vomiting, renal failure, and urinary tract bleeding. In landmark univariate survival analyses, hydronephrosis was associated with worse survival at all time points. In landmark multivariate analyses (adjusted for patient age, stage, cancer treatment, and tumor histology), hydronephrosis was associated with a trend toward worse survival over time (hazard ratios ranged from 1.47 to 4.69).

Conclusion

Hydronephrosis in cervical cancer patients is associated with notable morbidity. It is also associated with trends toward worse survival—even if it occurs after the original cancer diagnosis.

Keywords

Hydronephrosis Morbidity Cervical cancer 

Notes

Funding

This work was funded by 5K24CA131099.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Krishna Patel
    • 1
  • Nathan R. Foster
    • 2
  • Amanika Kumar
    • 3
  • Megan Grudem
    • 4
  • Sherri Longenbach
    • 4
  • Jamie Bakkum-Gamez
    • 3
  • Michael Haddock
    • 5
  • Sean Dowdy
    • 3
  • Aminah Jatoi
    • 4
    • 6
    Email author
  1. 1.Department of MedicineMayo ClinicRochesterUSA
  2. 2.Division of Biomedical Statistics and InformaticsMayo ClinicRochesterUSA
  3. 3.Division of Gynecologic SurgeryMayo ClinicRochesterUSA
  4. 4.Department of OncologyMayo ClinicRochesterUSA
  5. 5.Department of Radiation OncologyMayo ClinicRochesterUSA
  6. 6.RochesterUSA

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