Uropatía obstructiva en cáncer de testículo: características clínicas al momento del diagnóstico oncológico

Abstract

Background

During testicular cancer progression, retroperitoneal activity can condition urinary compression, especially in advanced stages. When this presents, it requires urinary diversion.

Aim

To describe the clinical presentation of obstructive uropathy (OU) associated with testicular cancer at the time of diagnosis, correlating the variables of the neoplasia to establish associations between the 2 entities.

Material and methods

A retrospective study encompassing the time frame from July 2010 to June 2015 was conducted that included 98 patients with testicular cancer, evaluating the presence of OU through abdominal tomography and statistical analysis for the purpose of establishing significant associations between the variables.

Results

Twenty patients (20.2%) presented with OU, with a mean age of 24 years, ECOG 1, and a progression time of 305 days. Eight patients had seminomatous tumor (40%) and 12 had nonseminomatous tumor (60%), of which the most frequent histology was endodermal sinuses (66%), followed by embryonal carcinoma and teratoma (50%, respectively). The mean size of the lymph node conglomerate was 4.3 cm, 65% of the patients had metastasis upon diagnosis, and the most frequent clinical stage was IIIC (50%). Forty percent of the patients had elevated creatinine.

There were no statistically significant results between the development of retroperitoneal disease and histology (P = 0.72), progression time (P = 0.44), or laterality (P = 0.44).

Testicular tumor size was correlated with the development of OU (P < 0.05), the same as was stage pT (P < 0.05), stage N (P < 0.05), metastases (P = 0.001), LDH (P < 0.05), clinical stage (P < 0.05), and young age (P < 0.05)

Conclusions

OU is a comorbidity associated with germ cell testicular cancer that usually involves advanced stages. Young patients with poor functional status, with large tumors, and elevated LDH levels after orchiectomy should be evaluated to rule out urinary compression.