title: Current outcome of patients with ureteral stents for the management of malignant ureteral obstruction.
abstract: OBJECTIVE
  We analyzed the prognostic factors associated with overall survival and predictive factors of stent failure in patients treated with an indwelling retrograde ureteral stent for malignant ureteral obstruction.
  
  
  METHODS
  Among 186 Japanese patients treated with an indwelling retrograde ureteral stent for ureteral obstruction from January 2005 to March 2010, 61 with malignant ureteral obstruction and 95 ureteral units were analyzed retrospectively.
  
  
  RESULTS
  Median survival was estimated at 228 days. Unfavorable prognostic factors of overall survival were no treatment after indwelling retrograde ureteral stent placement (p = 0.023) and a serum creatinine before indwelling retrograde ureteral stent placement of 1.2 mg/dl or greater (p = 0.016). Overall survival differed significantly among cancer groups (p <0.001) as did stent failure-free survival (p = 0.011). Overall survival differed significantly among 3 risk groups divided according to the score calculated with regard to prognostic factors (p <0.001).
  
  
  CONCLUSIONS
  Gynecologic cancer was a significant favorable predictor of stent failure-free survival. Patients treated with an indwelling retrograde ureteral stent for malignant ureteral obstruction were divided into 3 groups, which showed significant differences in overall survival. This risk classification may help urologists predict survival time.
authors.affiliation: Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan. azuizu2003@yahoo.co.jp
authors.forename: Kouji
authors.initials: K
authors.lastname: Izumi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Mizokami
authors.forename: Yuji
authors.initials: Y
authors.lastname: Maeda
authors.forename: Eitetsu
authors.initials: E
authors.lastname: Koh
authors.forename: Mikio
authors.initials: M
authors.lastname: Namiki
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D019544:Equipment Failure Analysis; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications* / Q000473:pathology; D005833:Genital Neoplasms, Female / Q000150:complications / Q000473:pathology; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010166:Palliative Care / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011475:Prosthesis Failure; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D015607:Stents / Q000009:adverse effects; D016019:Survival Analysis; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000209:etiology / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D014571:Urologic Neoplasms / Q000150:complications / Q000473:pathology