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    Interventions for obstructive uropathy in advanced prostate cancer: a population-based study

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    Authors
    Nathan, A.
    Morris, M.
    Parry, M. G.
    Berry, B.
    Sujenthiran, A.
    Nossiter, J.
    Payne, H.
    Van Der Meulen, J.
    Clarke, Noel W
    Green, J. S. A.
    Affiliation
    Clinical Effectiveness Unit, The Royal College of Surgeons of England, United Kingdom
    Issue Date
    2022
    
    Metadata
    Show full item record
    Abstract
    Objectives: Upper tract obstructive uropathy (UTOU) is a complication of advanced prostate cancer (PCa) that may require urinary tract decompression. There are no population-based studies on the incidence, treatment, and outcomes of this complication. We developed and validated a coding framework to identify procedures for UTOU in men with locally advanced and metastatic PCa using administrative hospital data to assess clinical outcomes. Patients and methods: Patients newly diagnosed with PCa between April 2014 and March 2019 were identified in the English cancer registry. A coding framework based on procedure (OPCS-4) and diagnostic (ICD-10) codes was developed and validated. Subsequent clinical outcomes were determined using Hospital Episodes Statistics (HES) to determine the utility of the intervention. Results: A total of 77,010 patients newly diagnosed with locally advanced, and 30,083 patients with metastatic PCa were identified. Of these, 1,951 (1.8%) patients underwent an intervention for UTOU according to our coding framework: 830 (42.5%) had locally advanced disease and 1,121 (57.5%) had metastatic disease. 844 (43.3%) had a percutaneous nephrostomy (PCN), 473 (24.2%) had a PCN with antegrade stent and 634 (32.5%) had a retrograde stent. Mean follow-up time was 43.2 months. The cumulative incidence of the use of these interventions at one, three, and five years was 2.5%, 3.6% and 4.2% in men with metastases compared to 0.5%, 0.9% and 1.4% in men with locally advanced disease. Conclusion: A new coding framework, developed to identify procedures for UTOU. was applied in the largest study to date of UTOU in men with primary locally advanced and metastatic PCa. Results demonstrated that 2% of men with locally advanced PCa and 4% of men with metastatic PCa require an intervention to resolve UTOU within 5 years of their PCa diagnosis.
    Citation
    Nathan A, Morris M, Parry MG, Berry B, Sujenthiran A, Nossiter J, et al. Interventions for obstructive uropathy in advanced prostate cancer: a population‐based study. BJU International. Wiley; 2022.
    Journal
    BJU International
    URI
    http://hdl.handle.net/10541/625269
    DOI
    10.1111/bju.15766
    PubMed ID
    35485254
    Additional Links
    https://dx.doi.org/10.1111/bju.15766
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1111/bju.15766
    Scopus Count
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