Prognostic Model for Predicting Survival After Palliative Urinary Diversion for Ureteral Obstruction: Analysis of 140 Cases

Ishioka, Junichiro; Kageyama, Yukio; Inoue, Masaharu; Higashi, Yotsuo; Kihara, Kazunori

doi:10.1016/j.juro.2008.04.011

Cited by 72 publications

(102 citation statements)

References 9 publications

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“…A recent study reviewed all such patients at an institution who were treated with either ureteral stenting or percutaneous nephrostomy tubes. 31 In this group, the median overall survival was only 96 days. Therefore, the various treatment options available must improve quality of life to be of a significant benefit.…”

Section: What Is the Prognosis In Obstructive Uropathy?mentioning

confidence: 80%

Obstructive Uropathy

Girardi

Martin

2015

Hospital Medicine Clinics

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Section: What Is the Prognosis In Obstructive Uropathy?mentioning

confidence: 80%

Obstructive Uropathy

Girardi

Martin

2015

Hospital Medicine Clinics

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“…In this study, it was shown that patients with three or more events related to malignant dissemination (for instance, liver metastasis or ascites), low degree of hydronephrosis, and low serum albumin before diversion had the shortest survival time and should therefore probably be spared the burden of the nephrostomy tube. 15 The second question to be answered once a decision has been made to proceed with urinary diversion is: ''Which is the best available option for achieving this goal?'' The urologist has to judge the best means of diversion, taking into consideration the patient's current status, quality-of-life issues, predicted survival, and cost.…”

Section: Should Obstruction Be Relieved and When?mentioning

confidence: 99%

“…PCN placement for extrinsic ureteral compression has remarkable technical success rates (96% to 100%) compared with retrograde stent placement in reversing upper-tract obstruction. 3,15,34,36,[41][42][43][44][45][46] Endoscopic placement of a stent in the setting of advanced malignancy has been considered technically demanding or even impossible in cases of extensive pelvic disease. Results from early series reported very low success rates for primary retrograde placement of a stent, rarely exceeding 50%.…”

mentioning

confidence: 99%

Endourologic Management of Malignant Ureteral Obstruction: Indications, Results, and Quality-of-Life Issues

Sountoulides

Pardalidis

Sofikitis

2010

Journal of Endourology

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Obstruction of the upper urinary tract is a problem commonly faced by practicing urologists. The constant evolution in endourology has effectively facilitated minimally invasive management of upper-tract obstruction. In a case in which malignancy is the cause of obstruction, however, the situation significantly changes. Questions arise regarding the need for relieving the obstruction, the means to accomplish this, and the benefits and drawbacks of each technique regarding both their efficacy and their impact on the patients well-being and the crucial issue of quality of life in the face of malignancy.

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“…4,5 Despite the controversy in the management of this condition and the accepted poor prognosis, most patients receive percutaneous nephrostomy tubes (PNTs), retrograde ureteric stents or both. 1,[6][7][8] In contrast, those with benign causes have cause-specific interventions and do well. We sought to describe the etiology, management and outcome in a contemporary cohort of patients with ARKI secondary to BUO who had malignant or benign disease and to compare them to a similar historical group.…”

Section: Introductionmentioning

confidence: 99%

Acute reversible kidney injury secondary to bilateral ureteric obstruction

Organ

Norman

2013

CUAJ

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Background: Acute reversible kidney injury (ARKI) secondary to bilateral ureteric obstruction (BUO) is a common urological problem. Our goals were to describe the etiology, management and outcomes of such patients identified between 2006 and 2009 and to compare them with a similar historical study published in 1982. Methods: Chart review was performed on 49 patients with AKRI secondary to BUO. ARKI was defined as ≥33% decrease in serum creatinine after intervention. Those with malignant and benign causes of obstruction were identified and management and outcome data were collected. Results: Of these 49 patients, 83% had BUO secondary to malignancy, 28% of these presenting for the first time. Prevalence of bladder cancer was increased (p = 0.04) and cervix trended lower (p = 0.07) compared with the earlier study; prostate cancer was unchanged (p = 0.51). The average survival was 239 days; 90% of patients died within a year after presenting with BUO from a malignant etiology. Compared with the 1982 group, there were trends towards a decrease in the frequency of retroperitoneal fibrosis (p = 0.08) and an increase in bilateral ureteric calculi (p = 0.16) in the benign group. Conclusions: Patients with ARKI secondary to BUO most likely have an underlying malignancy, with almost a third of them being diagnosed for the first time. Prevalence of bladder cancer increased while cervical cancer trended lower. The cause for the former is unclear; the latter may be due to aggressive screening. Prostate cancer remained unchanged despite the widespread implementation of prostate-specific antigen testing. Patients with an underlying malignancy do poorly and those with a newly diagnosed malignancy do worst. Those with ARKI secondary to benign causes did well.

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Prognostic Model for Predicting Survival After Palliative Urinary Diversion for Ureteral Obstruction: Analysis of 140 Cases

Abstract: The current stratification model may represent a useful tool for clinicians treating patients with ureteral obstruction due to advanced cancer.

Cited by 72 publications

References 9 publications

Obstructive Uropathy

Obstructive Uropathy

Endourologic Management of Malignant Ureteral Obstruction: Indications, Results, and Quality-of-Life Issues

Acute reversible kidney injury secondary to bilateral ureteric obstruction

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