title: Effect of hydronephrosis on survival in advanced stage cervical cancer.
abstract: BACKGROUND
  Hydronephrosis is frequently encountered in advanced stage cervical cancers, and may be associated with mortality. In the present study, we aimed to demonstrate the effect of hydronephrosis on survival in patients with inoperable advanced stage cervical cancer.
  
  
  METHODS
  The study data were acquired by retrospective analysis of the patient records belonging to 165 women with FIGO (International Federation of Gynecology and Obstetrics) stage-IIIB or more advanced cervical cancer, which were not surgical candidates. Parameters including patient age, pathological diagnosis, disease stage, pelvic sidewall extension, presence of hydronephrosis and administration of chemoradiation were analyzed. Further, the effects of these variables on survival were assessed. P values less than 0.05 were considered statistically significant.
  
  
  RESULTS
  The distribution of the study patients according to disease stage was as follows: 131 (79.4%) had stage-IIIB, 18 (10.9%) had stage-IVB and 16 (% 9.7) patients had stage-IVA disease. Hydronephrosis was not evident in 91 (55.2%) of these patients, whereas 41 (24.8%) had unilateral and 33 (20%) patients had bilateral hydronephrosis. When compared to mean survival in patients who did not have hydronephrosis, survival was significantly shortened in patients who had bilateral and unilateral hydronephrosis (p<0.05). There was no significant survival difference between patients with unilateral and bilateral hydronephrosis (p>0.05). Although patient age, pathological type, pelvic involvement, and chemotherapy treatment rates were similar (p>0.05), radiotherapy requirement rate and disease stage were significantly different among the study groups (p<0.05).
  
  
  CONCLUSIONS
  Hydronephrosis was found to be a significant predictor of poor survival in patients with advanced stage cervical cancer, irrespective of unilateral or bilateral involvement.While waiting for future studies with larger sample sizes, we believe that the FIGO stages in advanced cervical cancer could further be stratified into subgroups according to presence or absence of hydronephrosis.
authors.affiliation: Obstetrics and Gynecology Department, Diyarbakir Maternity Hospital, Diyarbakir, Turkey E-mail : doga_seckin@hotmail.com.
authors.forename: Mehmet Rıfat
authors.initials: MR
authors.lastname: Goklu
authors.forename: Kerem Doga
authors.initials: KD
authors.lastname: Seckin
authors.forename: Cihan
authors.initials: C
authors.lastname: Togrul
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Goklu
authors.forename: Ali Emre
authors.initials: AE
authors.lastname: Tahaoglu
authors.forename: Murat
authors.initials: M
authors.lastname: Oz
authors.forename: Ibrahim Egemen
authors.initials: IE
authors.lastname: Ertas
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000401:mortality* / Q000556:secondary; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001918:Brachytherapy; D018196:Carcinoma, Adenosquamous / Q000150:complications / Q000401:mortality* / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000401:mortality* / Q000556:secondary; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000150:complications / Q000401:mortality*; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents