title: Predicting the failure of retrograde ureteral stent insertion for managing malignant ureteral obstruction in outpatients.
abstract: Malignant ureteral obstruction (MUO) is an unpropitious sign that is commonly observed in patients with advanced incurable cancer. The present study aimed to evaluate predictive factors for the failure of retrograde ureteral stent insertion in the management of MUO in outpatients. A total of 164 patients with MUO were retrospectively assessed in this study. Clinical factors, including age, gender, type of malignancy, level of obstruction, cause of obstruction, pre-operative creatinine level, degree of hydronephrosis, condition of the contralateral ureter, prior radiotherapy, Eastern Cooperative Oncology Group performance status (ECOG PS), bladder wall invasion and technical failure, were recorded for each case. Univariate and multivariate logistic regression analyses were used to investigate the risk factors for predicting the failure of retrograde ureteral stent insertion. In total, 38 out of 164 patients experienced bilateral obstruction, therefore, a total of 202 ureteral units were available for data analysis. The rate of insertion failure in MUO was 34.65%. Multivariate analyses identified ECOG PS, degree of hydronephrosis and bladder wall invasion as independent predictors for insertion failure. Overall, the present study found that rate of retrograde ureteral stent insertion failure is high in outpatients with MUO, and that ECOG PS, degree of hydronephrosis and bladder invasion are potential independent predictors of insertion failure.
authors: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200011, P.R. China; Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.
authors: Jin-You
authors: JY
authors: Wang
authors: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200011, P.R. China; Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.
authors: Hai-Liang
authors: HL
authors: Zhang
authors: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200011, P.R. China; Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.
authors: Yao
authors: Y
authors: Zhu
authors: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200011, P.R. China; Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.
authors: Xiao-Jian
authors: XJ
authors: Qin
authors: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200011, P.R. China; Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.
authors: B O
authors: BO
authors: Dai
authors: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200011, P.R. China; Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.
authors: Ding-Wei
authors: DW
authors: Ye
keywords: malignant ureteral obstruction; predictive factor; retrograde ureteral stenting