Department of Urology, Tokyo Metropolitan Tama Medical Center, 2-9-2 Musashi-dai, Fuchu, Tokyo, Japan.
Clin Genitourin Cancer. 2013 Sep;11(3):353-6. doi: 10.1016/j.clgc.2013.04.030. Epub 2013 Jun 17.
To investigate the relationship between overall survival (OS) and prognostic risk factors for patients with malignant ureteral obstruction.
We retrospectively evaluated 214 patients who had received a nephrostomy for ureteral obstruction because of malignancy. Univariate and multivariate Cox regression models addressed OS.
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.
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.
探讨伴有恶性输尿管梗阻患者的总生存期（OS）与预后危险因素之间的关系。
我们回顾性评估了 214 例因恶性肿瘤而行输尿管梗阻肾造口术的患者。单因素和多因素 Cox 回归模型分析了 OS。
中位 OS 为 6.4 个月。1、3、6 和 12 个月的 OS 分别为 89.5%、72.4%、53.0%和 26.5%。使用单因素 Cox 回归分析，血清肌酐水平（P=0.0131）、白蛋白（P<0.0001）、钠（P<0.0001）、钾（P=0.0141）、校正钙（P=0.0167）、C 反应蛋白（P<0.0001）、白细胞计数（P=0.0246）和与恶性播散相关的事件数（P<0.0001）与 OS 相关。使用多因素 Cox 回归分析，白蛋白（P=0.0147）、钠（P=0.0046）、C 反应蛋白（P<0.0001）和与恶性播散相关的事件数（P=0.0002）是 OS 的独立预测因素。
PCN 前血清白蛋白和钠水平较低以及与恶性播散相关的事件数是预后不良的独立因素。使用多变量分析，高血清 C 反应蛋白水平也与预后不良相关。
