title: Prognostic marker for patients with malignant ureter obstruction.
abstract: OBJECTIVE
  To investigate the relationship between overall survival (OS) and prognostic risk factors for patients with malignant ureteral obstruction.
  
  
  METHODS
  We retrospectively evaluated 214 patients who had received a nephrostomy for ureteral obstruction because of malignancy. Univariate and multivariate Cox regression models addressed OS.
  
  
  RESULTS
  The median OS was 6.4 months. The OS at 1, 3, 6, and 12 months were 89.5%, 72.4%, 53.0%, and 26.5%, respectively. Using univariate Cox regression analysis, serum levels of creatinine (P = .0131), albumin (P < .0001), sodium (P < .0001), potassium (P = .0141), corrected calcium (P = .0167), C-reactive protein (P < .0001), white blood cell count (P = .0246), and the number of events related to malignant dissemination (P < .0001) were associated with OS. Using multivariate Cox regression analysis, serum levels of albumin (P = .0147), sodium (P = .0046), C-reactive protein (P < .0001), and the number of events related to malignant dissemination (P = .0002) were independent predictors of OS.
  
  
  CONCLUSIONS
  Low serum levels of albumin and sodium and the number of events related to malignant dissemination before PCN were independent factors associated with a poor prognosis. High serum C-reactive protein level was also associated with a poor prognosis using multivariate analysis.
authors.affiliation: Department of Urology, Tokyo Metropolitan Tama Medical Center, 2-9-2 Musashi-dai, Fuchu, Tokyo, Japan. azumamifune@yahoo.co.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Azuma
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Nagase
authors.forename: Masaya
authors.initials: M
authors.lastname: Oshi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D009403:Nephrostomy, Percutaneous; D011379:Prognosis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D012964:Sodium / Q000097:blood; D013534:Survival; D014516:Ureteral Neoplasms / Q000097:blood* / Q000601:surgery*; D014517:Ureteral Obstruction / Q000097:blood* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor; D012709:Serum Albumin; D002097:C-Reactive Protein; D012964:Sodium
keywords: Cancer; Hydronephrosis; Percutaneous nephrostomy; Prognosis factor