Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan.
J Urol. 2011 Feb;185(2):556-61. doi: 10.1016/j.juro.2010.09.102. Epub 2010 Dec 18.
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.
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.
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).
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.
我们分析了留置逆行输尿管支架治疗恶性输尿管梗阻患者的总生存相关预后因素和支架失败的预测因素。
2005 年 1 月至 2010 年 3 月期间，186 例因输尿管梗阻接受留置逆行输尿管支架治疗的日本患者中，61 例为恶性输尿管梗阻，95 个输尿管单位进行回顾性分析。
中位生存时间估计为 228 天。总生存的不利预后因素包括留置逆行输尿管支架后无治疗（p = 0.023）和留置逆行输尿管支架前血清肌酐为 1.2mg/dl 或更高（p = 0.016）。不同癌症组之间的总生存差异显著（p <0.001），支架无失败生存差异也显著（p = 0.011）。根据预后因素计算的评分将患者分为 3 个风险组，总生存差异显著（p <0.001）。
妇科癌症是支架无失败生存的显著有利预测因素。接受留置逆行输尿管支架治疗恶性输尿管梗阻的患者分为 3 组，总生存差异显著。这种风险分类可能有助于泌尿科医生预测生存时间。
