title: The outcome with ureteric stents for managing non-urological malignant ureteric obstruction.
abstract: OBJECTIVE
  To investigate the clinical outcome using ureteric stents to manage ureteric obstruction in advanced non-urological malignancies.
  
  
  METHODS
  We retrospectively reviewed the use of ureteric stents (Endo-sof, Cook Urological, Spencer, IN, USA) placed for malignant ureteric obstruction from June 2001 to September 2006. The clinical and radiological variables for predicting the failure of stent insertion, functional stent failure and death were analysed.
  
  
  RESULTS
  In all, 86 patients with a non-urological malignant ureteric obstruction were treated by ureteric stenting; 13 (15%) had failure of retrograde stent insertion, and of the remaining 73, 12 (16%) had stent failures during the subsequent follow-up. The risk of failure for stent insertion significantly increased with male gender (hazard ratio 6.45, P = 0.028) and the presence of bladder invasion (hazard ratio 27.04, P < 0.001). There was no independent predictor of stent failure in univariate analysis. Of the 86 patients, 54 (63%) died with a mean survival time of 8.6 months after an initial attempt to place a stent, and 41 (48%) died within 1 year. Multivariate analysis showed that low performance status, upper ureteric obstruction and no chemotherapy after stenting were independently associated with a poor prognosis (P = 0.03, 0.004 and 0.003, respectively).
  
  
  CONCLUSIONS
  The method of diversion for a malignant ureteric obstruction should be carefully discussed with male patients or if there is bladder invasion. Patients with a low performance status, upper ureteric obstruction and no scheduled chemotherapy after stenting had a poor survival time.
authors.affiliation: Urologic Oncology Clinic, National Cancer Center, Goyang, Korea.
authors.forename: In Gab
authors.initials: IG
authors.lastname: Jeong
authors.forename: Kyung Seok
authors.initials: KS
authors.lastname: Han
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Joung
authors.forename: Ho Kyung
authors.initials: HK
authors.lastname: Seo
authors.forename: Jinsoo
authors.initials: J
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D012737:Sex Factors; D015607:Stents; D016019:Survival Analysis; D014517:Ureteral Obstruction / Q000209:etiology / Q000401:mortality / Q000601:surgery*