Evidence map›Paper›PMID 32319003›Full record

ArticleInternational urology and nephrology2020

Percutaneous nephrostomy in obstructing pelvic malignancy does not facilitate further oncological treatment.

Samuel Stephen Folkard, Srijit Banerjee, Richard Menzies-Wilson, Joseph Reason, Evangelos Psallidas, Elliot Clissold, Ahmad Al-Mushatat, Saurabh Chaudhri, James Stephen Arthur Green

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in International urology and nephrology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Review
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  7. Acute Kidney Injury in the Patient with Cancer.Diagnostics (Basel, Switzerland) · 2021
    Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Samuel Stephen FolkardDepartment of Urology, Whipps Cross Hospital, Whipps Cross Rd., Leytonstone, London, E11 1NR, UK. samuel.folkard@googlemail.com.
Srijit BanerjeeDepartment of Urology, Royal London Hospital, Whitechapel Rd., Whitechapel, London, E1 1FR, UK.
Richard Menzies-WilsonDepartment of Urology, Whipps Cross Hospital, Whipps Cross Rd., Leytonstone, London, E11 1NR, UK.
Joseph ReasonDepartment of Urology, Whipps Cross Hospital, Whipps Cross Rd., Leytonstone, London, E11 1NR, UK.
Evangelos PsallidasDepartment of Urology, Royal London Hospital, Whitechapel Rd., Whitechapel, London, E1 1FR, UK.
Elliot ClissoldDepartment of Urology, Whipps Cross Hospital, Whipps Cross Rd., Leytonstone, London, E11 1NR, UK.
Ahmad Al-MushatatDepartment of Urology, Royal London Hospital, Whitechapel Rd., Whitechapel, London, E1 1FR, UK.
Saurabh ChaudhriDepartment of Nephrology, Whipps Cross Hospital, Whipps Cross Rd., Leytonstone, London, E11 1NR, UK.
James Stephen Arthur GreenDepartment of Urology, Whipps Cross Hospital, Whipps Cross Rd., Leytonstone, London, E11 1NR, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe optimal management of patients with ureteric obstruction in advanced malignancy is unclear. How quality of life is affected by a nephrostomy and how many of these patients undergo further oncological treatment remains uncertain. The objective of this retrospective multicentre study was to look at the outcomes of patients who had percutaneous nephrostomy insertion for malignancy.

methodsWe identified patients who had a nephrostomy inserted for ureteric obstruction due to malignancy at our institution from January 2015 to December 2018. We obtained data retrospectively from our electronic patient record system. Patients who had nephrostomy insertion for other causes such as ureteric calculi or injury were excluded from the study.

results105 patients underwent nephrostomy insertion during this time interval. 51.42% patients (n = 54) had urological malignancies (bladder and/or prostate cancer). The median LOS was 14 days (range 1-104 days) post-procedure and 39.04% (n = 41) had at least one 30-day readmission to hospital. The average starting creatinine level was 348 mmol/L (range 49-1133) and the average creatinine at discharge was 170 mmol/L (range 44-651). Although the average change in the creatinine (190 mmol/L) is statistically significant (p < 0.001), it did not seem to prolong life of the patients. Only 26 (24.76%) patients were alive (all-cause mortality) at the end of the 4-year period with an average life expectancy of 139 days following nephrostomy. Only 30.47% (n = 32) patients underwent further oncological treatment.

conclusionIn our series, most patients who had nephrostomy insertion for ureteric obstruction due to malignancy had no further oncological treatment following insertion. Percutaneous nephrostomy is a procedure not without associated morbidity and does not always prolong survival. Due to the poor prognosis in cases of advanced malignancy, we advocate multi-disciplinary decision-making prior to nephrostomy insertion.

Indexed as

Nephrostomy, PercutaneousAdultAgedAged, 80 and overHumansMaleMiddle AgedProstatic NeoplasmsRetrospective StudiesUreteral ObstructionUrinary Bladder NeoplasmsNephrostomyObstructing pelvic malignancyQuality of Life

Identifiers

PMID32319003

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.