1 Department of Urology, Queen Elizabeth University Hospital Campus, Glasgow G51 4TF, UK.
2 Urological Research Unit, Queen Elizabeth University Hospital Campus, Glasgow G51 4TF, UK.
J R Soc Med. 2018 Apr;111(4):125-135. doi: 10.1177/0141076818766725.
Over the last thirty years, the management of Malignant Ureteric Obstruction (MUO) has evolved from a single disciplinary decision to a multi-disciplinary approach. Careful consideration must be given to the risks and benefits of decompression of hydronephrosis for an individual patient. There is a lack of consensus of opinion as well as strong evidence to support the decision process. Outcomes that were identified amongst patients undergoing treatment for MUO included prognosis, quality of life (QOL), complications, morbidity and prognostication tools. A total of 63 papers were included. Median survival was 6.4 months in the 53 papers that stated this outcome. Significant predictors to poor outcomes included low serum albumin, hyponatremia, the number of malignancy related events, and performance status of 2 or worse on the European cooperative cancer group. We propose a multi-centre review of outcomes to enable evidence-based consultations for patients and their families.
在过去的三十年中，恶性输尿管梗阻 (MUO) 的治疗已经从单一的学科决策演变为多学科的方法。必须仔细考虑为单个患者解除肾积水的风险和益处。在支持决策过程方面，目前缺乏共识和强有力的证据。在接受 MUO 治疗的患者中，确定的结果包括预后、生活质量 (QOL)、并发症、发病率和预后工具。共有 63 篇论文被纳入研究。在明确报告这一结果的 53 篇论文中，中位生存时间为 6.4 个月。预后不良的显著预测因素包括血清白蛋白低、低钠血症、与恶性肿瘤相关的事件次数以及欧洲癌症合作组织的体力状态为 2 或更差。我们建议对多中心的结果进行审查，以便为患者及其家属提供循证咨询。
