Predicting Factors for Stent Failure-Free Survival in Patients With a Malignant Ureteral Obstruction Managed With Ureteral Stents.
10.4111/kju.2013.54.5.316
- Author:
Seong Hyeon YU
1
;
Je Guk RYU
;
Se Heon JEONG
;
Eu Chang HWANG
;
Won Seok JANG
;
In Sang HWANG
;
Ho Song YU
;
Sun Ouck KIM
;
Seung Il JUNG
;
Taek Won KANG
;
Dong Deuk KWON
;
Kwangsung PARK
;
Jun Eul HWANG
;
Geun Soo KIM
Author Information
1. Department of Urology, Chonnam National University Medical School, Gwangju, Korea. urohwang@gmail.com
- Publication Type:Original Article
- Keywords:
Neoplasm metastasis;
Stents;
Ureteral obstruction
- MeSH:
C-Reactive Protein;
Creatinine;
Humans;
Hydronephrosis;
Hypoalbuminemia;
Multivariate Analysis;
Neoplasm Metastasis;
Proportional Hazards Models;
Retrospective Studies;
Serum Albumin;
Stents;
Ureter;
Ureteral Obstruction;
Urinary Bladder
- From:Korean Journal of Urology
2013;54(5):316-321
- CountryRepublic of Korea
- Language:English
-
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 (> or =1 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 > or =1 (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 > or =1, 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.
