Clinical profile and outcome of patients with cervical cancer submitted to hemodialysis at the Brazilian National Cancer Institute (INCA).

Abstract

e16502 Background: Cervical Cancer (CC) is a public health problem in Brazil. Yearly almost 650 CC patients (pts) are admitted at our center for treatment. Locally advanced disease represents 67.5% of all cases. Acute renal failure is a frequent consequence of local dissemination as well as treatment toxicity in these pts, leading to the necessity of hemodialysis (HD). Available data on the clinical spectrum and outcome of these hemodialysis-treated patients are inconclusive. Methods: This is a retrospective observational study. All cervical cancer diagnosed pts submitted to HD during the year of 2008 at INCA were included irrespective of age, stage or treatment modality. Primary end point was to describe the clinical profile and survival of patients submitted to HD. Clinical features, treatment and outcome were analyzed. Results: Data were available from 40 consecutive patients, 45% of them had PS Performance 0-I. Median age at diagnosis was 50y (33-83), 60% was white; squamous cell cancer represented 95% of cases; most patients were stage IIIB (65%) and IV (20%); only 20% of pts had chronic renal failure (nondialytic); the most common indication for hemodialysis was postrenal failure due to local progression and hydronephrosis (70%) and septic shock (15%); 25% received no treatment, 40% received only radiotherapy/brachytherapy during and after HD, and 35% received combined chemo/radiotherapy before/during HD; with 17 months (14- 24) of follow up, only 2 pts were alive, the median overall survival from the beginning of HD was 18 days (1-210). Conclusions: In this study, HD in pts with CC was associated with locally advanced tumors, and a poor overall survival. Further studies are necessary to better evaluate the real effects of this procedure in these pts in order to better define treatment selection. No significant financial relationships to disclose.