Treatment efficacy and prognosis analysis in locally advanced or metastatic colorectal cancer patients with hydronephrosis

Tong,Gangling; Chen,Boran; Zhang,Mingying; Wang,Tianyu; Wu,Xuan; Yan,Yuye; Wang,Shubin; Li,Shuluan

doi:10.3892/mco.2022.2539

Treatment efficacy and prognosis analysis in locally advanced or metastatic colorectal cancer patients with hydronephrosis

Authors:
- Gangling Tong
- Boran Chen
- Mingying Zhang
- Tianyu Wang
- Xuan Wu
- Yuye Yan
- Shubin Wang
- Shuluan Li
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Affiliations: Department of Oncology, Peking University Shenzhen Hospital, Shenzhen Key Laboratory of Gastrointestinal Cancer Translational Research, Cancer Institute of Shenzhen‑PKU‑HKUST Medical Center, Shenzhen, Guangdong 518036, P.R. China, Department of Breast Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong 518116, P.R. China
Published online on: April 20, 2022 https://doi.org/10.3892/mco.2022.2539
Article Number: 106

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Abstract

The effect of hydronephrosis, a common complication of metastatic colorectal cancer (CRC), on the treatment outcome and prognosis of locally advanced or metastatic CRC remains to be elucidated. The present study investigated the clinical characteristics, outcomes, and prognoses of patients with locally advanced or metastatic colorectal cancer (CRC) with hydronephrosis. Clinical data of patients with locally advanced or metastatic CRC who were attending Peking University Shenzhen Hospital and Shenzhen Cancer Hospital between January 2016 and December 2020 were retrospectively collected. A total of 52 patients with hydronephrosis based on CT or MRI findings were selected, and their clinical characteristics, treatment outcomes, and survival times were analyzed. Of the 52 patients, 33 were male (63.5%), and the median age was 49 years (range, 31‑76 years). A total of 15 (28.8%) patients with CRC had synchronous hydronephrosis and the remaining 37 patients had metachronous hydronephrosis. Ureters were either compressed by peritoneal or abdominal cavity metastatic lymph nodes in 34 cases (65.4%) or by direct tumor invasion in 18 cases (34.6%). However, objective response rate (ORR) was higher in the group in which ureters were compressed by peritoneal or abdominal cavity metastatic lymph nodes; ORR, disease control rate and median progression‑free survival (PFS) between the two groups were not statistically different. (P>0.05). The median survival period was only 27.0 months (95% CI, 20.549‑33.451) in patients complicated with malignant hydronephrosis. Univariate and multivariate analyses showed that CA19‑9 might be a prognostic factor for locally advanced and metastatic CRC patients with hydronephrosis. Metachronous metastatic CRC has a high incidence rate of complicated hydronephrosis. Targeted drugs in combination with chemotherapy improve the treatment efficacy and prognosis of patients. Notably, the present study found that CA19‑9 level might be a prognostic factor in CRC patients with hydronephrosis.

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1	Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A and Bray F: Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 71:209–249. 2021.PubMed/NCBI View Article : Google Scholar
2	Cao Y and Wang X: Effects of molecular markers on the treatment decision and prognosis of colorectal cancer: A narrative review. J Gastrointest Oncol. 12:1191–1196. 2021.PubMed/NCBI View Article : Google Scholar
3	Chen G, Peng J, Xiao Q, Wu HX, Wu X, Wang F, Li L, Ding P, Zhao Q, Li Y, et al: Postoperative circulating tumor DNA as markers of recurrence risk in stages II to III colorectal cancer. J Hematol Oncol. 14(80)2021.PubMed/NCBI View Article : Google Scholar
4	Zhang Q, Tey J, Yang Z, Li P, Peng L, Fu S, Huang G, Xiong F and Lu JJ: Adjuvant chemoradiation plus intraoperative radiotherapy versus adjuvant chemoradiation alone in patients with locally advanced rectal cancer. Am J Clin Oncol. 38:11–16. 2015.PubMed/NCBI View Article : Google Scholar
5	Kim DD, Litow KJ, Lumbra TJ and Masri MM: Failure of 3 different methods and biopsy sites to diagnose a patient with invasive colorectal cancer: A case report. Medicine (Baltimore). 98(e15656)2019.PubMed/NCBI View Article : Google Scholar
6	Brown G, Drury AE, Cunningham D and Husband JE: CT detection of hydronephrosis in resected colorectal cancer: A predictor of recurrent disease. Clin Radiol. 58:137–142. 2003.PubMed/NCBI View Article : Google Scholar
7	Larsen SG, Wiig JN and Giercksky KE: Hydronephrosis as a prognostic factor in pelvic recurrence from rectal and colon carcinomas. Am J Surg. 190:55–60. 2005.PubMed/NCBI View Article : Google Scholar
8	Sugimoto H, Oda G, Yokoyama M, Hayashi K, Yoshino M, Ogawa A, Hosoya T, Nakagawa T and Uetake H: Hydronephrosis caused by metastatic breast cancer. Case Rep Oncol. 14:378–385. 2021.PubMed/NCBI View Article : Google Scholar
9	Duan XH, Li FY, Han XW, Wu G, Zhang JH, Tian YD and Zhang YC: Clinical observation of double percutaneous nephrostomy combined with ureter occlusion stent for treating cervical cancer complicated with vesicovaginal fistula. Cancer Biother Radiopharm: Oct 5, 2020 (Epub ahead of print).
10	Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, et al: New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer. 45:228–247. 2009.PubMed/NCBI View Article : Google Scholar
11	McNamara DA, Fitzpatrick JM and O'Connell PR: Urinary tract involvement by colorectal cancer. Dis Colon Rectum. 46:1266–1276. 2003.PubMed/NCBI View Article : Google Scholar
12	Ghanem AI, Glide-Hurst C, Siddiqui MS, Chetty IJ and Movsas B: Retroperitoneal metastasis abutting small bowel: A novel magnetic resonance-guided radiation approach. Cureus. 10(e2412)2018.PubMed/NCBI View Article : Google Scholar
13	Aghalarov I, Forster S, Tannapfel A, Ubrig B, Uhl W and Belyaev O: A double metachronous ureter metastasis following curative resection of rectal cancer. Case Rep Gastroenterol. 15:450–455. 2021.PubMed/NCBI View Article : Google Scholar
14	Sato T, Sakai H, Goto Y, Kojima S, Nomura Y, Nakayama G, Hirakawa Y, Mikagi K, Kawahara R, Ishikawa H, et al: A case of laparoscopic hepatectomy and combined resection of lymph nodes and ureter for liver metastasis after colorectal cancer surgery, with local lymph node recurrence and bilateral hydronephrosis. Gan To Kagaku Ryoho. 46:751–753. 2019.PubMed/NCBI(In Japanese).
15	Lev-Chelouche D, Keidar A, Rub R, Matzkin H and Gutman M: Hydronephrosis associated with colorectal carcinoma: Treatment and outcome. Eur J Surg Oncol. 27:482–486. 2001.PubMed/NCBI View Article : Google Scholar
16	Cheng C, Rodriguez-Bigas MA and Petrelli N: Is there a role for curative surgery for pelvic recurrence from rectal carcinoma in the presence of hydronephrosis? Am J Surg. 182:274–277. 2001.PubMed/NCBI View Article : Google Scholar
17	Hamanaka M, Noda M, Imada A, Song J, Kimura K, Babaya A, Kobayashi M, Tsukamoto K, Takaki H, Yamano T, et al: Two cases of CT-guided radiofrequency ablation therapy for pelvic recurrence from rectal cancer. Gan To Kagaku Ryoho. 45:1794–1796. 2018.PubMed/NCBI(In Japanese).
18	Yoshitomi M, Hashida H, Nomura A, Ueda S, Terajima H and Osaki N: A case of locally advanced sigmoid colon cancer treated with neoadjuvant chemoradiotherapy. Gan To Kagaku Ryoho. 41:1175–1178. 2014.PubMed/NCBI(In Japanese).
19	Kagawa Y, Kato T, Naito A, Murakami K, Katsura Y, Ohmura Y, Okishiro M, Takeno A, Egawa C, Takeda Y and Tamura S: A case of consciousness disturbance caused by hyperammonemia during a mFOLFOX6 regimen for metastatic colon cancer. Gan To Kagaku Ryoho. 42:2160–2162. 2015.PubMed/NCBI(In Japanese).
20	Sakisaka H, Kato T, Kagawa Y, Ishida T, Sato Y, Morimoto Y, Matsushita K, Hashimoto T, Kusama H, Kimura K, et al: Cetuximab improved the poor performance status of a colorectal cancer patient. Gan To Kagaku Ryoho. 41:1776–1778. 2014.PubMed/NCBI(In Japanese).
21	Kuwabara H, Yamamoto Y, Baba H, Mitsuoka A, Nakamura H, Sanada T, Baba H, Goseki N, Hodotsuka M and Sano T: A patient with unresectable progressive advanced rectal cancer maintained in a state of remission by using combination therapy. Gan To Kagaku Ryoho. 39:1929–1931. 2012.PubMed/NCBI(In Japanese).
22	Aderka D, Stintzing S and Heinemann V: Explaining the unexplainable: Discrepancies in results from the CALGB/SWOG 80405 and FIRE-3 studies. Lancet Oncol. 20:e274–e283. 2019.PubMed/NCBI View Article : Google Scholar
23	Xiong L, Lou Y and Wang L: Effect of bevacizumab combined with first-line chemotherapy on metastatic colorectal cancer. Am J Transl Res. 13:3609–3617. 2021.PubMed/NCBI
24	Westberg K, Palmer G, Hjern F, Nordenvall C, Johansson H, Holm T and Martling A: Population-based study of factors predicting treatment intention in patients with locally recurrent rectal cancer. Br J Surg. 104:1866–1873. 2017.PubMed/NCBI View Article : Google Scholar
25	Henry LR, Sigurdson E, Ross E and Hoffman JP: Hydronephrosis does not preclude curative resection of pelvic recurrences after colorectal surgery. Ann Surg Oncol. 12:786–792. 2005.PubMed/NCBI View Article : Google Scholar
26	Tanaka T, Yanase M and Takatsuka K: Clinical course in patients with percutaneous nephrostomy for hydronephrosis associated with advanced cancer. Hinyokika Kiyo. 50:457–462. 2004.PubMed/NCBI
27	Haas CR, Shah O and Hyams ES: Temporal trends and practice patterns for inpatient management of malignant extrinsic ureteral obstruction in the United States. J Endourol. 34:828–835. 2020.PubMed/NCBI View Article : Google Scholar
28	Atar A, Oktar T, Kucukgergin C, Kalelioglu I, Seckin S, Ander H, Ziylan O and Kadioglu TC: The roles of serum and urinary carbohydrate antigen 19-9 in the management of patients with antenatal hydronephrosis. J Pediatr Urol. 11:133.e1–5. 2015.PubMed/NCBI View Article : Google Scholar