T Chen1, L Tian2, D Fan3, F Wu3, J Lu4, S Ding5. 1. Department of Pediatric Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, People's Republic of China. 2. Guilin Medical University, Guilin, 541000, Guangxi, People's Republic of China. 3. Department of Urology, Shandong Provincial Qianfoshan Hospital, Jinan, 250002, Shandong, People's Republic of China. 4. Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, Shandong, People's Republic of China. kyoto2310@sina.com. 5. Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, Shandong, People's Republic of China.
Abstract
PURPOSE: Accumulated evidences have reminded us that since the prognosis of retroperitoneal fibrosis (RPF) secondary to non-urology carcinoma is poor it is essential to distinguish this condition from others. The objective of this study is to investigate the clinical features and outcomes of this infrequent but life-threatening disease. METHODS: A total of 97 patients diagnosed with RPF secondary to non-urology carcinoma were enrolled in this retrospective study. The baseline information, history of carcinoma, clinical presentation, laboratory results, diagnosis, treatment and prognosis of the patients were collected and analyzed. RESULTS: The mean age was 62.32 ± 11.22 years (range 31-85 years). It took 16.72 ± 7.11 days (range 3-34 days) for the patients with originally unexplained hydronephrosis to get a definite diagnosis of RPF secondary to non-urology carcinoma. Imaging-confirmed RPF [confirmed by computed tomography (CT) or magnetic resonance imaging (MRI)] was found in 91 patients. Fifty-seven patients were diagnosed with histological-confirmed malignant RPF. Sixty-six patients received surgical interventions. Cystoscopy and double J tube were performed in 68 cases (102 sides, 172 times) and was failed in 93 times (54.07%). Pyelostomy was performed in 72 patients (92 sides) without a single failure. Furthermore, eighty patients received chemotherapy and/or radiotherapy. The 6-month survival since RPF secondary to non-urology carcinoma was confirmed was 30%. CONCLUSIONS: All patients with newly diagnosed unexplained hydronephrosis should undergo an age-appropriate carcinoma screening. The prognosis of RPF secondary to non-urology carcinoma was dismal. When dealing with hydronephrosis affecting renal function, pyelostomy instead of double J tube catheterization should be performed ahead of time.
PURPOSE: Accumulated evidences have reminded us that since the prognosis of retroperitoneal fibrosis (RPF) secondary to non-urology carcinoma is poor it is essential to distinguish this condition from others. The objective of this study is to investigate the clinical features and outcomes of this infrequent but life-threatening disease. METHODS: A total of 97 patients diagnosed with RPF secondary to non-urology carcinoma were enrolled in this retrospective study. The baseline information, history of carcinoma, clinical presentation, laboratory results, diagnosis, treatment and prognosis of the patients were collected and analyzed. RESULTS: The mean age was 62.32 ± 11.22 years (range 31-85 years). It took 16.72 ± 7.11 days (range 3-34 days) for the patients with originally unexplained hydronephrosis to get a definite diagnosis of RPF secondary to non-urology carcinoma. Imaging-confirmed RPF [confirmed by computed tomography (CT) or magnetic resonance imaging (MRI)] was found in 91 patients. Fifty-seven patients were diagnosed with histological-confirmed malignant RPF. Sixty-six patients received surgical interventions. Cystoscopy and double J tube were performed in 68 cases (102 sides, 172 times) and was failed in 93 times (54.07%). Pyelostomy was performed in 72 patients (92 sides) without a single failure. Furthermore, eighty patients received chemotherapy and/or radiotherapy. The 6-month survival since RPF secondary to non-urology carcinoma was confirmed was 30%. CONCLUSIONS: All patients with newly diagnosed unexplained hydronephrosis should undergo an age-appropriate carcinoma screening. The prognosis of RPF secondary to non-urology carcinoma was dismal. When dealing with hydronephrosis affecting renal function, pyelostomy instead of double J tube catheterization should be performed ahead of time.
Authors: Peter G Rose; Shamshad Ali; Charles W Whitney; Rachelle Lanciano; Frederick B Stehman Journal: Gynecol Oncol Date: 2010-02-24 Impact factor: 5.482