Asian Paciic Journal of Cancer Prevention, Vol 16, 2015 4219 DOI:http://dx.doi.org/10.7314/APJCP.2015.16.10.4219 Hydronephrosis and Survival in Advanced Cervical Cancer Cases Asian Pac J Cancer Prev, 16 (10), 4219-4222 Introduction Cervical cancer is a preventable and curable disease. Worldwide, in women under 45 years of age, it is the 2 nd most common type of cancer, and 3rd most common cause of cancer related death, following breast and lung cancer (Espey et al., 2007). According to year 2008 statistics, cervical cancer comprises 9% (539,800) of all cancer diagnoses, and 8% (275,100) of all cancer related deaths (Miller et al., 2008). In contrast with other gynecologic cancers, cervical cancer is staged clinically (Benedet et al., 2000; Pecorelli 2009). The International Federation of Gynecology and Obstetrics (FIGO) staging is preferred in these patients, as it is less resource intensive, is more sensitive in detection of locally advanced disease (tumor size, vaginal or parametrial involvement) and identiication of patients 1 Obstetrics and Gynecology Department, Diyarbakir Maternity Hospital, Diyarbakir, 2 Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, 3 Corum Hitit University, Corum, 4 Zekai Tahir Burak Women’s Health and Research Hospital, Ankara, 5 Tepecik Education and Research Hospital, Izmir, Turkey *For correspondence: doga_seckin@hotmail.com Abstract Background: Hydronephrosis is frequently encountered in advanced stage cervical cancers, and may be associated with mortality. In the present study, we aimed to demonstrate the effect of hydronephrosis on survival in patients with inoperable advanced stage cervical cancer. Materials and Methods: The study data were acquired by retrospective analysis of the patient records belonging to 165 women with FIGO (International Federation of Gynecology and Obstetrics) stage-IIIB or more advanced cervical cancer, which were not surgical candidates. Parameters including patient age, pathological diagnosis, disease stage, pelvic sidewall extension, presence of hydronephrosis and administration of chemoradiation were analyzed. Further, the effects of these variables on survival were assessed. P values less than 0.05 were considered statistically signiicant. Results: The distribution of the study patients according to disease stage was as follows: 131 (79.4%) had stage-IIIB, 18 (10.9%) had stage-IVB and 16 (% 9.7) patients had stage-IVA disease. Hydronephrosis was not evident in 91 (55.2%) of these patients, whereas 41 (24.8%) had unilateral and 33 (20%) patients had bilateral hydronephrosis. When compared to mean survival in patients who did not have hydronephrosis, survival was signiicantly shortened in patients who had bilateral and unilateral hydronephrosis (p < 0.05). There was no signiicant survival difference between patients with unilateral and bilateral hydronephrosis (p>0.05). Although patient age, pathological type, pelvic involvement, and chemotherapy treatment rates were similar (p>0.05), radiotherapy requirement rate and disease stage were signiicantly different among the study groups (p<0.05). Conclusions: Hydronephrosis was found to be a signiicant predictor of poor survival in patients with advanced stage cervical cancer, irrespective of unilateral or bilateral involvement.While waiting for future studies with larger sample sizes, we believe that the FIGO stages in advanced cervical cancer could further be stratiied into subgroups according to presence or absence of hydronephrosis. Keywords: Cervical cancer - hydronephrosis - stage - survival RESEARCH ARTICLE Effect of Hydronephrosis on Survival in Advanced Stage Cervical Cancer Mehmet Rıfat Goklu 1 , Kerem Doga Seckin 2 *, Cihan Togrul 3 , Yasemin Goklu 1 , Ali Emre Tahaoglu 1 , Murat Oz 4 , Ibrahim Egemen Ertas 5 that are poor surgical candidates (Jemal et al., 2011). Parametrial involvement is critical in these patients, as its presence is considered a contraindication for surgery. Iniltration of the bladder and ureter by the tumor results in hydronephrosis, and consequently, a non- functional kidney. Obstructive uropathy is encountered in 14 to 44 percent of the cases with cervical cancer, and is a common cause of cervical cancer related mortality (Chao et al. 1998; Rose et al., 2010; Wit and Horenbas, 2014; Patel et al., 2015). Besides medical treatment, percutaneous nephrostomy and ureteral stent placement is commonly undertaken. However, these interventions have not proven useful in prolongation of survival (Lee and Jones 1994; Pradhan et al., 2011). In the present study, we aimed to demonstrate the effect of hydronephrosis on survival in Turkish patients with inoperable advanced stage cervical cancer.