Prognostic significance of urinary tract involvement by cervical carcinoma

✍ Scribed by Dean K. Midboe; J. W. Roddick Jr.; Frank H. Catron

• Publisher: John Wiley and Sons
• Year: 1969
• Tongue: English
• Weight: 197 KB
• Volume: 24
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(196907)24:1<84::aid-cncr2820240111>3.0.co;2-f

✦ Synopsis

Ninety-two patients with urinary tract abnormalities related to cervical cancer were studied. Of this group, only 15 are living without disease following treatment. The relative survival of the patients with urinary tract involvement was the same regardless of the stage of disease. I t can b e concluded that cancer of the cervix with urinary tract involvement carries a grave but not hopeless prog nosis.

HE LARGEST SINGLE CAUSE OF DEATH IN

T patients with carcinoma of the uterine cervix is urinary obstruction. T h e mortality from urinary tract involvement has been placed as high as 40% by some investigators.& Diehl and Hundley state that, in 1858, Wagner reported the presence of marked ureteral dilatation in one third of the women who died of cervical carcinoma.3 Aldridge and Mason studied 458 patients of whom 333 had intravenous urograms performed prior to treatment. All of the patients had Stage I or more advanced disease. Of the 333 investigated, 219 were found to have normal pyelograms, while 115 had abnormalities that were considered to be related to the carcinoma. Of the group with abnormal pyelograms, the gross survival rate was only 16%, while in those with normal urinary tracts, the survival rate was 62%. Barber, Roberts, and Brunsch-wig2 studied 503 patients who were treated with pelvic exenteration and urinary tract diversion. Ninety-nine patients survived for 5 years or more, a survival rate of 19.7%. Four hundred and nine of these patients had intravenous pyelograms which showed no obstruction. I n this group, 89 (or 22%) survived 5 years. Sixty-eight had unilateral nonvisualization on pyelogram. Seven of these, or 10.2%, were living at 5 years. Of 32 patients with