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19–22 APRIL, 2017, BARCELONA, SPAIN
S17: OBSTRUCTION &
HYDRONEPHROSIS
Moderators: Jorge Caffaratti (Spain), Josef Oswald (Austria)
ESPU Meeting on Friday 21, April 2017, 14:45–15:40
14:45–14:48
S17-1 (PP)
★
URINARY CARBOHYDARTE ANTIGEN 19-9 MAY PREDICT
FAILURE OF NON-OPERATIVE MANAGEMENT IN CHILDREN
WITH URETEROPELVIC JUNCTION OBSTRUCTION
Behnam NABAVIZADEH
1
, Abdol-Mohammad KAJBAFZADEH
1
,
Reza KHORRAMIROUZ
1
, Erfan AMINI
2
, Asal HOJJAT
1
and Farhad PISHGAR
2
1) Tehran University of Medical Sciences, Pediatric Urology and Regenerative Medicine Research Center, Pediatric
Center of Excellence, Tehran, ISLAMIC REPUBLIC OF IRAN - 2) Tehran University of Medical Sciences, Uro-oncology
Research Center, Tehran, ISLAMIC REPUBLIC OF IRAN
PURPOSE
Surgical intervention is indicated in children with ureteropelvic junction obstruction (UPJO) with
deteriorating renal function. Determining predicting factors is of great value in identifying kidneys
which might benefit from early surgical intervention. We conducted this study to assess the role of
urinary carbohydrate antigen 19-9 (CA19-9) measurement in determining optimal management of
children with UPJO.
MATERIAL AND METHODS
The patients were divided into three groups: Patients in group 1 required immediate pyeloplasty.
Group 2 were suitable for observation; however due to the deterioration of condition pyeloplasty
was indicated after a period of observation. Group 3 consisted of patients who were considered
for non-operative management with improvement of the condition during the course of follow up.
RESULTS
A total of 124 children (127 affected kidneys) with UPJO and median age of 4.7 months were
considered in this study. 39 patients (31.5%) underwent pyeloplasty (group 1), whereas 85 patients
were considered for non-operative management. Crossover from observation to pyeloplasty was
necessary in 28 patients out of 85 (32.9%) patients (group 2) and the remaining 57 patients showed
significant improvement in APD. Mean urinary CA19-9 level was 224.6±232.5, 134.4±89.3 and
37.0±37.5 in group 1, 2 and 3 patients, respectively. ROC curve analysis revealed that urinary
CA19-9 level at cut off value of 25 has 93% sensitivity and 50% specificity in predicting failure of
non-operative treatment. Multivariate analysis showed that both CA19-9 and APD were independ-
ent predictors of need for surgery.
CONCLUSIONS
Higher urinary CA19-9 level is associated with failure of non-operative management in patients with
UPJO.