The outcome with ureteric stents for managing non-urological malignant ureteric obstruction.
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.
Jeong
In Gab
IG
Urologic Oncology Clinic, National Cancer Center, Goyang, Korea.
Han
Kyung Seok
KS
Joung
Jae Young
JY
Seo
Ho Kyung
HK
Chung
Jinsoo
J
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*