title: Hydronephrosis in children with abdominal and pelvic neoplasms: outcome and survival analysis of a single center pediatric oncology series.
abstract: OBJECTIVE
  We ascertained the incidence and outcome of hydronephrosis related to abdominal or pelvic neoplasms and survival in pediatric patients.
  
  
  METHODS
  We retrospectively reviewed our institutional oncology database between January 1995 and November 2009. We reviewed the charts of all children with intra-abdominal (nonrenal) and pelvic neoplasms.
  
  
  RESULTS
  Of the 366 patients whose charts were reviewed 66 (18%) had hydronephrosis at some point during treatment, including 12 with hydronephrosis that was not caused by the neoplasm and 1 who was lost to followup, leaving 53 with malignant obstruction. Of the remaining patients hydronephrosis resolved in 34 (64%) with treatment for the primary neoplasm alone while in 19 (36%) hydronephrosis persisted after primary oncological treatment. Univariate analysis revealed that patients with persistent hydronephrosis (p = 0.025), those with urological intervention (p = 0.05) and those with high stage disease (p <0.001) had statistically significantly worse overall survival. On Cox multivariate analysis only disease stage remained statistically significant (p = 0.004).
  
  
  CONCLUSIONS
  Analysis of this group revealed that pediatric nonrenal abdominal and pelvic tumors are associated with hydronephrosis in about 20% of cases. Approximately 60% of these cases resolved with treatment for the primary tumor alone while 13% required specific urological intervention for urinary tract involvement or compression. Patients with pediatric malignant ureteral obstruction had a 20% 5-year mortality rate. The main predictive factor was primary disease stage.
authors.affiliation: Division of Urology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Angus
authors.initials: A
authors.lastname: Alexander
authors.forename: Bryce
authors.initials: B
authors.lastname: Weber
authors.forename: Armando
authors.initials: A
authors.lastname: Lorenzo
authors.forename: Melise
authors.initials: M
authors.lastname: Keays
authors.forename: Tarek
authors.initials: T
authors.lastname: El-Ghazaly
authors.forename: Darius J
authors.initials: DJ
authors.lastname: Bägli
authors.forename: João L
authors.initials: JL
authors.lastname: Pippi Salle
authors.forename: Meredith
authors.initials: M
authors.lastname: Irwin
authors.forename: Walid
authors.initials: W
authors.lastname: Farhat
mesh_terms: D000008:Abdominal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009864:Ontario / Q000453:epidemiology; D010386:Pelvic Neoplasms / Q000150:complications* / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014517:Ureteral Obstruction / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D013520:Urologic Surgical Procedures