Authors: Jones, Oliver M.; John, Solomon K.P.; Lawrance, Richard J.; Fozard, J Basil J.

Source: Annals of The Royal College of Surgeons of England, Volume 89, Number 4, May 2007 , pp. 414-417(4)

Publisher: The Royal College of Surgeons of England

Abstract:

INTRODUCTION: Ureteric obstruction is a potentially terminal event in patients with irresectable or recurrent colorectal cancer. Urinary tract obstruction is easily relieved by either two stage antegrade stenting or one stage retrograde stenting. However, there is little in the literature about outcomes after this procedure and it is unclear which, if any, patients should be offered this intervention.

PATIENTS AND METHODS: This was a retrospective review of a prospectively collected database of patients diagnosed with colorectal cancer. This database comprised 1428 cases (operative and non-operative) diagnosed at a single institution. This was cross-checked with databases for patients undergoing nephrostomy and/or antegrade stenting and by clinical coding for those patients having retrograde stenting between January 1996 and October 2004.

RESULTS: Thirteen patients were identified (median age, 69 years: range, 35-85 years; 9 male). The aetiology of obstruction was recurrent tumour in 6 patients and irresectable tumour in the remaining 7 patients. Two patients were discussed at a urology multidisciplinary meeting before stenting and a further two were discussed with colorectal surgeons. One patient received a palliative cystectomy and ileal conduit for a vesicovaginal fistula followed by radiotherapy. Four patients received chemotherapy after stenting. Overall median survival was 210 days (range, 13-927 days).

CONCLUSIONS: Long-term survival is possible in selected patients with recurrent or irresectable colorectal cancer and malignant ureteric obstruction. This appears to be more likely in those patients in whom other treatments, particularly chemotherapy, are available.

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Keywords: COLORECTAL CANCER; NEPHROSTOMY

Document Type: Research article

DOI: http://dx.doi.org/10.1308/003588407X183382

Affiliations: 1: Department of Colorectal Surgery, Royal Bournemouth Hospital, Bournemouth, UK

Publication date: 2007-05-01

More about this publication?

• The Annals of The Royal College of Surgeons of England is the official journal of the College and is published eight times a year in January, March, April, May, July, September, October and November. The main aim of the journal is to publish high quality, peer-reviewed papers that relate to all branches of surgery.
  
  The Annals also includes letters and comments, a regular technical section, NICE news, controversial topics, CORESS feedback, book reviews and the best trainee presentations from England and Wales. The editorial board is composed of members of the College Council and experts from across the surgical specialties.
  
  Archive issues of the Annals of The Royal College of Surgeons of England are available via the PubMed Central database
  
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