title: Factors associated with outcome after superior hypogastric plexus neurolysis in cancer patients.
abstract: OBJECTIVE
  Superior hypogastric plexus neurolysis (SHP-N) has been shown in uncontrolled studies to provide intermediate-term benefit in a majority of patients with pain secondary to genitourinary, gynecologic, and colorectal cancers. The purpose of this is to determine factors associated with treatment outcome.
  
  
  METHODS
  Patients who underwent SHP-N after a positive prognostic block were identified based on diagnostic classification and procedural codes from databases at 2 large teaching hospitals. A host of demographic, clinical, and treatment factors were examined for their association with treatment success, which was defined as ≥50% pain relief lasting ≥1 month.
  
  
  RESULTS
  A total of 53.1% of 32 patients with sufficient medical records for analysis experienced a positive outcome. Those with a positive outcome were older (mean age 59.6 y, SD 13.1 vs. 47.8, SD 15.6; P=0.03), less likely to have pelvic pain (36.8% success rate, P=0.04), and more likely to have bladder cancer (88.9% success rate; P=0.01) than those with a negative outcome. In stratified analysis, female were more likely to have positive outcome if they did not have pelvic pain compared to those that did (P=0.008). This difference was not significant for males.
  
  
  CONCLUSIONS
  Selecting patients based on demographic and clinical variables may improve treatment outcomes for SHP-N. Larger, prospective studies are needed to confirm our results and better refine selection criteria better.
authors: Departments of *Anesthesiology & Critical Care Medicine †Physical Medicine & Rehabilitation, Johns Hopkins School of Medicine, Baltimore §Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD ‡Department of Pain Medicine, Cleveland Clinic Foundation, Cleveland, OH.
authors: Caleb E
authors: CE
authors: Kroll
authors: Brandon
authors: B
authors: Schartz
authors: Marlis
authors: M
authors: Gonzalez-Fernandez
authors: Andrew H
authors: AH
authors: Gordon
authors: Mosunmola
authors: M
authors: Babade
authors: Michael A
authors: MA
authors: Erdek
authors: Nagy
authors: N
authors: Mekhail
authors: Steven P
authors: SP
authors: Cohen
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015179:Colorectal Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D007001:Hypogastric Plexus / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D018579:Patient Selection; D017699:Pelvic Pain / Q000209:etiology / Q000517:prevention & control*; D011379:Prognosis; D012189:Retrospective Studies; D017678:Sex Distribution; D016896:Treatment Outcome; D014565:Urogenital Neoplasms / Q000150:complications*; D055815:Young Adult