Predicting Factors for Stent Failure-Free Survival in Patients With a Malignant Ureteral Obstruction Managed With Ureteral Stents
À¯¼ºÇö, À¯Á¦±¹, Jeong Se-Heon, ȲÀÇâ, Àå¿ø¼®, À¯È£¼Û, ±è¼±¿Á, Á¤½ÂÀÏ, °Åÿø, ±Çµ¿µæ, ¹Ú±¤¼º, ȲÁØÀÏ, ±è±Ù¼ö, ȲÀλó,
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À¯¼ºÇö ( Yu Seong-Hyeon )
Chonnam National University Medical School Department of Urology
À¯Á¦±¹ ( Ryu Je-Guk )
Chonnam National University Medical School Department of Urology
( Jeong Se-Heon )
Chonnam National University Medical School Department of Urology
ȲÀÇâ ( Hwang Eu-Chang )
Chonnam National University Medical School Department of Urology
Àå¿ø¼® ( Jang Won-Seok )
Chonnam National University Medical School Department of Urology
À¯È£¼Û ( Yu Ho-Song )
Chonnam National University Medical School Department of Urology
±è¼±¿Á ( Kim Sun-Ouck )
Chonnam National University Medical School Department of Urology
Á¤½ÂÀÏ ( Jung Seung-Il )
Chonnam National University Medical School Department of Urology
°Åÿø ( Kang Taek-Won )
Chonnam National University Medical School Department of Urology
±Çµ¿µæ ( Kwon Dong-Deuk )
Chonnam National University Medical School Department of Urology
¹Ú±¤¼º ( Park Kwang-Sung )
Chonnam National University Medical School Department of Urology
ȲÁØÀÏ ( Hwang Jun-Eul )
Chonnam National University Medical School Department of Hematology-Oncology
±è±Ù¼ö ( Kim Geun-Soo )
Gwangju Hospital Department of Urology
ȲÀλó ( Hwang In-Sang )
Chonnam National University Medical School Department of Urology
KMID : 0358320130540050316
Abstract
Purpose: To determine predictive factors for stent failure-free survival in patients treated with a retrograde ureteral stent for a malignant ureteral obstruction.
Materials and Methods: We retrospectively reviewed 71 patients who underwent insertion of a cystoscopic ureteral stent due to a malignant ureteral obstruction between May 2004 and June 2011. Performance status, type of cancer, hydronephrosis grade, location of the obstruction, presence of bladder invasion, C-reactive protein (CRP), serum albumin, and inflammation-based prognostic score (Glasgow prognostic score, GPS) were assessed using a Cox proportional regression hazard model as predicting factors for stent failure.
Results: A univariate analysis indicted that hypoalbuminemia (<3.5 g/dL; hazard ratio [HR], 2.43; 95% confidence interval [CI], 1.21 to 4.86; p=0.012), elevated CRP (¡Ã1 mg/dL; HR, 4.79; 95% CI, 2.0 to 11.1; p=0.001), and presence of a distal ureter obstruction (HR, 3.27; 95% CI, 1.19 to 8.95; p=0.021) were associated with stent failure-free survival. A multivariate analysis revealed that the presence of a mid and lower ureteral obstruction (HR, 3.27; 95% CI, 1.19 to 8.95; p=0.007), GPS ¡Ã1 (HR, 7.22; 95% CI, 2.89 to 18.0; p=0.001), and elevated serum creatinine before ureteral stent placement (>1.2 mg/dL; HR, 2.16; 95% CI, 1.02 to 4.57; p=0.044) were associated with stent failure-free survival.
Conclusions: A mid or lower ureteral obstruction, GPS ¡Ã1, and serum creatinine before ureteral stent insertion >1.2 mg/dL were unfavorable predictors of stent failure-free survival. These factors may help urologists predict survival time.
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Neoplasm metastasis;Stents;Ureteral obstruction
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