REEVALUATION OF INDICATIONS FOR PERCUTANEOUS NEPHROSTOMY AND INTERVENTIONAL URORADIOLOGICAL PROCEDURES IN PELVIC MALIGNANCY

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.