[Percutaneous nephrostomy in neoplasm patients: when?].
The management of cancer patients with a lesion in its end stage is a clinical problem a satisfactory solution to which has not been found yet, because of the ethical and legal problems involved. The authors analyzed the survival rates of 218 patients with advanced neoplastic disease and obstructive renal failure who had undergone external/internal urinary diversion. One month after the procedure 20% of the patients were dead. The figure rose to 75% at 6 months and reached 98% at one year. Urinary diversion in cancer patients with renal failure is aimed not only at avoiding death and assuring a prolonged survival, but also at providing a good quality of life. Several clinical criteria are therefore analyzed which are used in the selection of patients to submit to nephrostomy. The most important factors seem to be the actual stage of the tumor, its primary location, the possibility of an effective antineoplastic therapy, and the patient's consent. Randomized long-term studies are still necessary to analyze not only survival rates but also quality of life after urinary diversion for obstructive renal failure.
Losinno
F
F
Servizio di Radiologia, Ospedale Policlinico S. Orsola Malpighi, Bologna.
Pavlica
P
P
Mami
A
A
Mattioli
R
R
Poggi
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D014463:Ultrasonography; D016055:Urinary Retention / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D014551:Urinary Tract / Q000000981:diagnostic imaging; D014571:Urologic Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy*
Nefrostomia percutanea nei pazienti neoplastici: quando?