Prognostic factors in malignant ureteric obstruction

OBJECTIVE To validate a model to stratify patients with obstructive nephropathy due to malignant ureteric obstruction, associated with a poor prognosis, into different prognostic groups, as a recent report identified low serum albumin, degree of hydronephrosis and number of events related to metasta...

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Bibliographic Details
Published in:BJU international 2009-10, Vol.104 (7), p.938-941
Main Authors: Lienert, Andrew, Ing, Andrew, Mark, Stephen
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Female
Humans
Hydronephrosis - etiology
Hydronephrosis - mortality
Kaplan-Meier Estimate
Male
Medical sciences
Middle Aged
Neoplasms - complications
Neoplasms - mortality
Neoplasms - surgery
Nephrology. Urinary tract diseases
nephrostomy
Nephrostomy, Percutaneous - mortality
Palliative Care
Prognosis
Retrospective Studies
Risk Assessment
Serum Albumin - metabolism
Ureteral Obstruction - etiology
Ureteral Obstruction - mortality
Ureteral Obstruction - surgery
ureteric obstruction
urinary diversion
Urinary system involvement in other diseases. Miscellaneous
Urinary tract. Prostate gland
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Summary:OBJECTIVE To validate a model to stratify patients with obstructive nephropathy due to malignant ureteric obstruction, associated with a poor prognosis, into different prognostic groups, as a recent report identified low serum albumin, degree of hydronephrosis and number of events related to metastatic disease as prognostic indicators before palliative decompression. PATIENTS AND METHODS We retrospectively review the charts to identify all patients who had a nephrostomy tube inserted for malignant ureteric obstruction. Laboratory and clinical factors that might influence prognosis were reviewed to attempt to externally validate the previously identified factors and model for risk stratification. RESULTS The median (range) age of the 49 patients identified was 71 (36–91) years, and the median survival was 174 (14–602) days. Tumours were of urological origin in 66% of patients. Patients with prostate cancer had nephrostomy tubes indwelling for a mean of 279 days, vs 190 days (P = 0.07) for patients with tumours not of prostatic origin. A serum albumin level of >30 g/L (P ≤ 0.001), serum sodium
ISSN:1464-4096
1464-410X
DOI:10.1111/j.1464-410X.2009.08492.x