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EP1051 Is treating malignant obstructive uropathy in advanced cervical cancer as futile as we think?
  1. D Mahajan1,
  2. T Shylasree1,
  3. U Mahantshetty2,
  4. N Shetty3,
  5. S Chopra2,
  6. R Kerkar1 and
  7. A Maheshwari1
  1. 1Gynaecological Oncology
  2. 2Radiation Oncology
  3. 3Intervention Radiology, Tata Memorial Centre, Mumbai, India

Abstract

Introduction/Background Advanced cancer cervix with obstructive uropathy has poor prognosis and these patients are rarely eligible for curative treatment. Overall survival of advanced stage III/IV cancer cervix with obstructive uropathy is less than 15–20%. However, performing percutaneous nephrostomy (PCN) might prolong life to some extent in order to bid good bye needs to be balanced against the complications and side effects of the procedure itself. Also it is thought that death from uremia is kinder in this situation.

Aim: To assess the feasibility of treatment interventions in prolonging life of patients diagnosed with advanced cancer cervix with obstructive uropathy.

Methodology Retrospective analysis of 15 patients with a diagnosis of advanced cancer cervix and impaired renal function underwent PCN & ureteral catheterization during a 12 month period (2016) at a tertiary cancer center.

Results Out of 15 patients, 9 patients had stage III B and 6 stage IV disease. Following PCN, 3 patients received radical treatment with curative intent and 12 treated with palliative intent (Radiotherapy/chemotherapy). The time period from PCN to starting treatment was 48 days (20–140), and total duration of treatment was 114 days(28–311). All patients died within 12 months of initial diagnosis of malignant obstructive uropathy.

Conclusion Treatment of uropathy in advanced Cancer cervix does help to tide over the imminent uremic state. This will make them eligible for some form of palliative treatment to prolong life in months when uropathy is treated instead of weeks if left untreated. The goals of intervention in such patients needs to be redefined and should be discussed on one on one basis. Patient's wishes for prolongation of life for various reasons and QoL issues needs to be factored in during consultations.

Disclosure Nothing to disclose

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