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Abstract：
OBJECTIVE: Urinary diversion is the treatment of choice for cervical cancer patients with urinary tract obstruction. The aim of this study is to determine the survival rate among advanced cervical cancer patients with hydronephrosis who undergo urinary diversion and factors that affect patient survival.
METHODS: Clinical data of cervical cancer patients with International Federation of Gynecology and Obstetrics (FIGO) Stage-IIIB or advanced cervical cancer were not surgical candidates admitted to Saiful Anwar Hospital, Malang from May 2016 to August 2022 were retrospectively analyzed. The parameters including age, cancer stage, comorbidity, cancer treatment at diagnosis, hydronephrosis treatment, grade, site, and survival, were analyzed using the IBM SPSS Statistics version 21. The significance level was set up to 0.05.
RESULTS: One hundred eighteen patients were included in this study. Most patients were under 60 (84.75%) and presented with stage IIIB (79.66%). Diabetes mellitus type 2 (8.47%), hypertension (7.63%), acute kidney injury (16.10%), and chronic kidney disease (36.78%) were comorbidities discovered in patients. More than half of patients received chemotherapy (54.24%). Ureteral stents were inserted in 85.59% of patients. Patients with moderate hydronephrosis were the most common, accounting for 67.80% of all cases. Patients with bilateral hydronephrosis outnumber those with unilateral by 91.53% to 8.47%. The survival rate did not differ significantly between ureteral stents (median survival was 11.00 months) and percutaneous nephrostomies (median survival was 15.00 months), p=0.749. In univariate analysis, age, cancer stage, and hydronephrosis stage were associated with worse 1-year survival. In multivariate analysis, age, DM type 2, cancer staging and hydronephrosis staging were associated with worse 1-year survival.
CONCLUSIONS: In advanced cervical cancer patients, urinary diversion techniques such as ureteral stents and percutaneous nephrostomy offer similar survival rates. In addition, age, cancer stage, DM type 2, and hydronephrosis site are strong predictors of a worsening survival rate in patients.
METHODS: Clinical data of cervical cancer patients with International Federation of Gynecology and Obstetrics (FIGO) Stage-IIIB or advanced cervical cancer were not surgical candidates admitted to Saiful Anwar Hospital, Malang from May 2016 to August 2022 were retrospectively analyzed. The parameters including age, cancer stage, comorbidity, cancer treatment at diagnosis, hydronephrosis treatment, grade, site, and survival, were analyzed using the IBM SPSS Statistics version 21. The significance level was set up to 0.05.
RESULTS: One hundred eighteen patients were included in this study. Most patients were under 60 (84.75%) and presented with stage IIIB (79.66%). Diabetes mellitus type 2 (8.47%), hypertension (7.63%), acute kidney injury (16.10%), and chronic kidney disease (36.78%) were comorbidities discovered in patients. More than half of patients received chemotherapy (54.24%). Ureteral stents were inserted in 85.59% of patients. Patients with moderate hydronephrosis were the most common, accounting for 67.80% of all cases. Patients with bilateral hydronephrosis outnumber those with unilateral by 91.53% to 8.47%. The survival rate did not differ significantly between ureteral stents (median survival was 11.00 months) and percutaneous nephrostomies (median survival was 15.00 months), p=0.749. In univariate analysis, age, cancer stage, and hydronephrosis stage were associated with worse 1-year survival. In multivariate analysis, age, DM type 2, cancer staging and hydronephrosis staging were associated with worse 1-year survival.
CONCLUSIONS: In advanced cervical cancer patients, urinary diversion techniques such as ureteral stents and percutaneous nephrostomy offer similar survival rates. In addition, age, cancer stage, DM type 2, and hydronephrosis site are strong predictors of a worsening survival rate in patients.
摘要：
目的：尿路改道是宫颈癌合并尿路梗阻的首选治疗方法。这项研究的目的是确定患有肾积水的晚期宫颈癌患者进行尿流改道的生存率以及影响患者生存率的因素。
方法：国际妇产科联合会（FIGO）IIIB期或晚期宫颈癌患者的临床数据不是SaifulAnwar医院收治的手术候选人，对2016年5月至2022年8月的Malang进行回顾性分析。参数包括年龄，癌症阶段，合并症，诊断时的癌症治疗，肾积水治疗,grade,site,和生存，使用IBMSPSSStatistics21版进行了分析。显著性水平设定为0.05。
结果：本研究纳入118例患者。大多数患者年龄在60岁以下（84.75％），并表现为IIIB期（79.66％）。2型糖尿病（8.47%），高血压（7.63%），急性肾损伤（16.10%），慢性肾脏病(36.78%)是患者发现的合并症。超过一半的患者接受了化疗(54.24%)。85.59%的患者置入输尿管支架。中度肾积水患者最常见，占所有病例的67.80%。双侧肾积水的患者比单侧肾积水的患者多91.53％至8.47％。输尿管支架（中位生存期为11.00个月）和经皮肾穿刺（中位生存期为15.00个月）之间的生存率没有显着差异，p=0.749。在单变量分析中，年龄,癌症阶段，肾积水阶段与较差的1年生存率相关。在多变量分析中，年龄,2型糖尿病，癌症分期和肾积水分期与较差的1年生存率相关。
结论：在晚期宫颈癌患者中，尿流改道技术，如输尿管支架和经皮肾造口术提供相似的存活率。此外,年龄,癌症阶段，2型糖尿病和肾积水部位是患者生存率恶化的有力预测因子。
方法：国际妇产科联合会（FIGO）IIIB期或晚期宫颈癌患者的临床数据不是SaifulAnwar医院收治的手术候选人，对2016年5月至2022年8月的Malang进行回顾性分析。参数包括年龄，癌症阶段，合并症，诊断时的癌症治疗，肾积水治疗,grade,site,和生存，使用IBMSPSSStatistics21版进行了分析。显著性水平设定为0.05。
结果：本研究纳入118例患者。大多数患者年龄在60岁以下（84.75％），并表现为IIIB期（79.66％）。2型糖尿病（8.47%），高血压（7.63%），急性肾损伤（16.10%），慢性肾脏病(36.78%)是患者发现的合并症。超过一半的患者接受了化疗(54.24%)。85.59%的患者置入输尿管支架。中度肾积水患者最常见，占所有病例的67.80%。双侧肾积水的患者比单侧肾积水的患者多91.53％至8.47％。输尿管支架（中位生存期为11.00个月）和经皮肾穿刺（中位生存期为15.00个月）之间的生存率没有显着差异，p=0.749。在单变量分析中，年龄,癌症阶段，肾积水阶段与较差的1年生存率相关。在多变量分析中，年龄,2型糖尿病，癌症分期和肾积水分期与较差的1年生存率相关。
结论：在晚期宫颈癌患者中，尿流改道技术，如输尿管支架和经皮肾造口术提供相似的存活率。此外,年龄,癌症阶段，2型糖尿病和肾积水部位是患者生存率恶化的有力预测因子。
