Revista de informes de casos clínicos

Experience of Successful Treatment for an Intractable Advanced Ureter Cancer with Extra ureteral Extension using Omental Flap Transposition: A Case Report

Abstract

Sung Han Kim, Sung Chan Park, Kwan Ho Cho, Sun Ho Kim, Jae Young Joung, Jinsoo Chung, Weon Seo Park, Kang Hyun Lee and Ho Kyung Seo

We report on a 61-year-old female case of advanced ureter cancer using omental flap transposition (OFT) with tumor reduction surgery before adjuvant pelvic irradiation to prolong survival and to prevent pelvic complication from irradiation, resulting in a stable disease state for one year without serious major morbidity. The patient presented with growing pelvic pain and constipation for three months without gross hematuria or flank pain. She was diagnosed with stage IV (T4N2M0) left distal ureter cancer extending to the left iliac vessels. After three cycles of neoadjuvant combination chemotherapy of gemcitabine-cisplatin, left nephroureterectomy with a resection of the bladder cuff and ipsilateral salphingo-oophorectomy with lymph node dissection, and segmental colon resection with OFT were performed. Then, 30 adjuvant radiations at a fractionated dose of 6880 cGy on left-sided pelvic areas enabled the patient to remain in a stable disease state without progression or loco-regional recurrence, and no severe complications occurred during follow-up. Therefore, owing to the OFT with surgical reduction of tumor burden, adjuvant high dosing radiotherapy was performed effectively and safely in advanced ureter cancer without occurrence of severe radiation-related complications.