Hydronephrosis or pelvic-mass-induced ureteric obstruction in cervical cancer (FIGO IIIB...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-CERVICAL-HYDRONEPHROSIS-PELVIC-OBSTRUCTION`
Type	Red flag
Status	reviewed 2026-04-26 \| pending_clinical_signoff
Diseases	`DIS-CERVICAL`
Sources	`SRC-ESMO-CERVICAL-2024` `SRC-NCCN-CERVICAL-2025`

Red Flag Origin

Definition	Hydronephrosis or pelvic-mass-induced ureteric obstruction in cervical cancer (FIGO IIIB by definition). Mandates urgent renal decompression (percutaneous nephrostomy or ureteric stent) BEFORE cisplatin-based CRT — cisplatin nephrotoxic + ureteric obstruction worsens AKI.
Clinical direction	hold
Category	organ-dysfunction

Trigger Logic

{
  "any_of": [
    {
      "finding": "hydronephrosis_grade2_plus",
      "value": true
    },
    {
      "finding": "creatinine_rising",
      "value": true
    },
    {
      "finding": "ureteric_obstruction_imaging",
      "value": true
    }
  ],
  "type": "composite_score"
}

Notes

FIGO IIIB definition includes hydronephrosis from tumor — substantial prognostic weight. Cisplatin radiosensitization needs CrCl ≥60; decompression first, restage CrCl, then proceed with CRT.

Used By

Indications

IND-CERVICAL-LOCALLY-ADVANCED-CRT - IND-CERVICAL-LOCALLY-ADVANCED-CRT
IND-CERVICAL-METASTATIC-1L-PEMBRO-CHEMO-BEV - IND-CERVICAL-METASTATIC-1L-PEMBRO-CHEMO-BEV