Jwm. Hoe et al., REEVALUATION OF INDICATIONS FOR PERCUTANEOUS NEPHROSTOMY AND INTERVENTIONAL URORADIOLOGICAL PROCEDURES IN PELVIC MALIGNANCY, British Journal of Urology, 71(4), 1993, pp. 469-472
Twenty-two patients with advanced cancer involving the pelvis were tre
ated by percutaneous uroradiological techniques. Percutaneous nephrost
omy was performed for renal failure or urosepsis or before chemotherap
y. In 8 patients, ureteric stents were also placed by the antegrade ro
ute, across malignant ureteric strictures, following nephrostomy. In a
nother 8 patients, the ureteric obstruction could not be crossed and p
ermanent nephrostomies were required. Fifteen patients were able to ac
hieve a useful life but in the other 7 patients there was no improveme
nt in their quality of life and they all died 1 month after interventi
on. Percutaneous nephrostomy also contributed to the death of 1 patien
t. Not all obstructed kidneys require drainage and in patients with di
sseminated or advanced disease involving the pelvis, the indications f
or intervention need to be individually assessed. An improvement in la
boratory criteria of renal function following intervention does not ne
cessarily result in improvement in quality of life. This retrospective
study highlights the difficulty in selection of patients with advance
d disease for intervention and previously suggested guidelines for int
ervention are reviewed.