Urinary Diversion Can Improve the Chance of Implementing New Therapeutic Lines in Patients with Malignant Ureteral Obstruction: A Multicenter Study

Purpose: Malignant ureteral obstruction is generally associated with a poor disease prognosis; therefore, managing these cases is challenging. We describe our experience in treating malignant ureteral obstruction with urinary diversion and the impact of these procedures on the indication for new ant...

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Main Authors: Marcelo Cartapatti, Roberto Dias Machado, José Carlos Mesquita, Raphael Freua, Diego Cáceres, Rodolfo Borges dos Reis
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Current Oncology
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Online Access:https://www.mdpi.com/1718-7729/31/11/523
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author Marcelo Cartapatti
Roberto Dias Machado
José Carlos Mesquita
Raphael Freua
Diego Cáceres
Rodolfo Borges dos Reis
author_facet Marcelo Cartapatti
Roberto Dias Machado
José Carlos Mesquita
Raphael Freua
Diego Cáceres
Rodolfo Borges dos Reis
author_sort Marcelo Cartapatti
collection DOAJ
description Purpose: Malignant ureteral obstruction is generally associated with a poor disease prognosis; therefore, managing these cases is challenging. We describe our experience in treating malignant ureteral obstruction with urinary diversion and the impact of these procedures on the indication for new antineoplastic therapy and survival. Materials and Methods: We retrospectively reviewed the data of patients with advanced cancer associated with malignant ureteral obstruction who underwent urinary diversion at three tertiary institutions between January 2013 and July 2022. Results: This study included 420 patients (mean age, 58.7 years (range, 18–90 years) with a mean follow-up of 20.3 months. Cervical (36.2%) and bladder cancers (18.6%) were the most prevalent primary neo-plastic sites. The mean creatinine values measured before diversion, 30 days after surgery, and most recently were 3.45, 1.84, and 2.59 mg/dL, respectively. In total, 300 patients (71.4%) received antineoplastic treatment, 195 received palliative treatment, and 105 received curative treatment. After an average of 251.87 postoperative days, 265 (64%) patients died. The mean overall survival was 610.76 days. Patients with prostate and cervical neoplasms had the most prolonged overall survival (573.13 and 549.28 days, respectively), whereas patients with bladder and colorectal cancer had the worst overall survival (480.25 and 370.53 days, respectively). Conclusions: Urinary diversion improves kidney function and opens a therapeutic window for a new line of antineoplastic therapy that provides a cure or increases patient survival.
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spelling doaj-art-56e1a2ee4dd24bec9da59d176c39b4322024-11-26T17:59:00ZengMDPI AGCurrent Oncology1198-00521718-77292024-11-0131117107711610.3390/curroncol31110523Urinary Diversion Can Improve the Chance of Implementing New Therapeutic Lines in Patients with Malignant Ureteral Obstruction: A Multicenter StudyMarcelo Cartapatti0Roberto Dias Machado1José Carlos Mesquita2Raphael Freua3Diego Cáceres4Rodolfo Borges dos Reis5Clinics Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, SP, BrazilBarretos Cancer Hospital, Barretos 14784-400, SP, BrazilSão José do Rio Preto Medical School (FAMERP), Av. Brigadeiro Faria Lima, 5416-Villa São Pedro, São José do Rio Preto 15090-000, SP, BrazilSão José do Rio Preto Medical School (FAMERP), Av. Brigadeiro Faria Lima, 5416-Villa São Pedro, São José do Rio Preto 15090-000, SP, BrazilBarretos Cancer Hospital, Barretos 14784-400, SP, BrazilClinics Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, SP, BrazilPurpose: Malignant ureteral obstruction is generally associated with a poor disease prognosis; therefore, managing these cases is challenging. We describe our experience in treating malignant ureteral obstruction with urinary diversion and the impact of these procedures on the indication for new antineoplastic therapy and survival. Materials and Methods: We retrospectively reviewed the data of patients with advanced cancer associated with malignant ureteral obstruction who underwent urinary diversion at three tertiary institutions between January 2013 and July 2022. Results: This study included 420 patients (mean age, 58.7 years (range, 18–90 years) with a mean follow-up of 20.3 months. Cervical (36.2%) and bladder cancers (18.6%) were the most prevalent primary neo-plastic sites. The mean creatinine values measured before diversion, 30 days after surgery, and most recently were 3.45, 1.84, and 2.59 mg/dL, respectively. In total, 300 patients (71.4%) received antineoplastic treatment, 195 received palliative treatment, and 105 received curative treatment. After an average of 251.87 postoperative days, 265 (64%) patients died. The mean overall survival was 610.76 days. Patients with prostate and cervical neoplasms had the most prolonged overall survival (573.13 and 549.28 days, respectively), whereas patients with bladder and colorectal cancer had the worst overall survival (480.25 and 370.53 days, respectively). Conclusions: Urinary diversion improves kidney function and opens a therapeutic window for a new line of antineoplastic therapy that provides a cure or increases patient survival.https://www.mdpi.com/1718-7729/31/11/523malignancyureteral obstructionurinary diversionkidney functionsurvival
spellingShingle Marcelo Cartapatti
Roberto Dias Machado
José Carlos Mesquita
Raphael Freua
Diego Cáceres
Rodolfo Borges dos Reis
Urinary Diversion Can Improve the Chance of Implementing New Therapeutic Lines in Patients with Malignant Ureteral Obstruction: A Multicenter Study
Current Oncology
malignancy
ureteral obstruction
urinary diversion
kidney function
survival
title Urinary Diversion Can Improve the Chance of Implementing New Therapeutic Lines in Patients with Malignant Ureteral Obstruction: A Multicenter Study
title_full Urinary Diversion Can Improve the Chance of Implementing New Therapeutic Lines in Patients with Malignant Ureteral Obstruction: A Multicenter Study
title_fullStr Urinary Diversion Can Improve the Chance of Implementing New Therapeutic Lines in Patients with Malignant Ureteral Obstruction: A Multicenter Study
title_full_unstemmed Urinary Diversion Can Improve the Chance of Implementing New Therapeutic Lines in Patients with Malignant Ureteral Obstruction: A Multicenter Study
title_short Urinary Diversion Can Improve the Chance of Implementing New Therapeutic Lines in Patients with Malignant Ureteral Obstruction: A Multicenter Study
title_sort urinary diversion can improve the chance of implementing new therapeutic lines in patients with malignant ureteral obstruction a multicenter study
topic malignancy
ureteral obstruction
urinary diversion
kidney function
survival
url https://www.mdpi.com/1718-7729/31/11/523
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