Management of the urinary tract involved by recurrent cancer
R. C. Eyre, P. N. Benotti, A. Bothe, B. Cady and G. Steele Jr
We present our experience from 1982 to the present in treating 33 patients
with recurrent cancers (colorectal, 22; gynecologic, six; breast, two;
melanoma, two; and lung, one) secondarily involving the genitourinary
tract. All patients had severe symptoms that required palliation.
Endoscopically placed stents relieved ureteral obstruction in 18 (75%) of
24 patients with widespread metastatic disease. Two patients required
percutaneous nephrostomy tubes, and five required open operations. Good to
excellent palliation was achieved in 23 of 24 patients. Mean survival in
the group with diffuse metastases was 13 months (range, six to 29 months).
Nine patients with localized recurrences underwent surgical procedures. For
localized pelvic recurrences, total exenteration (with or without
intraoperative radiotherapy) provided excellent palliation with low
morbidity. At the time of this report, five of six such patients had no
evidence of disease, and one had a small asymptomatic pelvic recurrence,
with a mean follow-up of 13 months (range, five to 19 months).
