Warli Syah Mirsya, Tala Mohd Rhiza Z, Wijaya William Saputra
Department of Urology, Faculty of Medicine, Universitas Sumatera Utara Hospital - Universitas Sumatra Utara, Medan, Indonesia.
Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara - Haji Adam Malik General Hospital, Medan, Indonesia.
World J Oncol. 2024 Apr;15(2):239-245. doi: 10.14740/wjon1631. Epub 2024 Mar 21.
Cervical cancer remains the most lethal and prevalent cancer among women. Obstructive uropathy is a common complication of advanced cervical cancer, caused by the expanding tumor. One of the recommended treatments for this condition is the implantation of a double J (DJ) stent. However, this procedure is challenging due to the unique characteristics of the patient. The objective of this study was to identify the variables that influence the successful insertion of a DJ stent in women with advanced cervical cancer.
This retrospective study included women who attempted to have a DJ stent implanted at the General Hospital of Adam Malik in Medan, Indonesia, between January 2020 and December 2022, and were diagnosed with advanced cervical cancer. The inclusion criteria were limited to cervical cancer patients in stages III-IV, according to the International Federation of Gynecology and Obstetrics (FIGO) staging standard, who underwent an attempt at DJ stent insertion. Patients who underwent a nephrostomy and received a DJ stent were excluded from the study. The participants were divided into two groups based on the success of the DJ stent implantation. The analysis was conducted using the logistic regression test and the Chi-square test.
The study included 88 patients with advanced-stage cervical cancer, of whom 45 underwent nephrostomy and 43 received a DJ stent. The analysis revealed that lower levels of hydronephrosis (odds ratio (OR): 18.203, P = 0.001), urea (OR: 4.207, P = 0.037), and creatinine (OR: 6.923, P = 0.004), higher levels of urine output (OR: 8.26, P = 0.003), and lower cervical cancer stage (OR: 4.125, P = 0.022) were all predictors of successful DJ stent insertion.
For women with advanced cervical cancer, lower degrees of hydronephrosis, urea, and creatinine levels, higher urine output, and lower cervical cancer stage were all predictive factors for successful DJ stent implantation.
宫颈癌仍是女性中最致命且最常见的癌症。梗阻性肾病是晚期宫颈癌的常见并发症，由肿瘤扩大所致。针对这种情况，推荐的治疗方法之一是植入双J（DJ）支架。然而，由于患者的独特特征，该手术具有挑战性。本研究的目的是确定影响晚期宫颈癌女性成功插入DJ支架的变量。
这项回顾性研究纳入了2020年1月至2022年12月期间在印度尼西亚棉兰的亚当·马利克综合医院尝试植入DJ支架且被诊断为晚期宫颈癌的女性。纳入标准仅限于根据国际妇产科联盟（FIGO）分期标准处于III - IV期且尝试进行DJ支架插入的宫颈癌患者。接受肾造瘘术并植入DJ支架的患者被排除在研究之外。根据DJ支架植入的成功情况将参与者分为两组。使用逻辑回归检验和卡方检验进行分析。
该研究包括88例晚期宫颈癌患者，其中45例行肾造瘘术，43例植入了DJ支架。分析显示，肾积水程度较低（比值比（OR）：18.203，P = 0.001）、尿素水平较低（OR：4.207，P = 0.037）、肌酐水平较低（OR：6.923，P = 0.004）、尿量较高（OR：8.26，P = 0.003）以及宫颈癌分期较低（OR：4.125，P = 0.022）均是DJ支架成功插入的预测因素。
对于晚期宫颈癌女性，肾积水、尿素和肌酐水平较低，尿量较高以及宫颈癌分期较低均是DJ支架植入成功的预测因素。
