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- Title
Outcome of Palliative Urinary Diversion and Observation for Malignant Extrinsic Ureteral Obstruction.
- Authors
Tatenuma, Tomoyuki; Tsutsumi, Sogo; Yasui, Masato; Noguchi, Go; Umemoto, Susumu; Kishida, Takeshi
- Abstract
Background: Urologists are often referred to manage the extrinsic malignant ureteral obstruction (MUO) caused by nonurological malignancies. Usually palliative urinary diversion (ureteral stent or nephrostomy) will be performed; however, in the cases of no symptom or poor prognosis, observation (OBS) without any intervention will be selected. There are few reports about outcome of the OBS policy for MUO. Objective: To evaluate the outcome of palliative urinary diversion or OBS for MUO. Design: We retrospectively reviewed the selection of treatment and the prognosis. Setting/Subjects: A total of 151 cases were introduced to our department as MUO between April 2011 and December 2016. Measurements: The patients were divided to immediate palliative urinary diversion (immediate-DIV) or OBS. The latter patients were subdivided to OBS followed by deferred palliative urinary diversion (deferred-DIV), and observation only (OBS-only). Results: There was no significant difference between immediate-DIV and OBS about overall survival (OS) from the consultation. In OBS group, deferred-DIV did not prolong prognosis from the consultation more than OBS-only. In the same way, there was no significant difference between immediate-DIV and deferred-DIV in OS from the intervention. Unfavorable prognostic factors for OS were lack of anticancer treatment after consultation, symptoms of MUO, and gastrointestinal cancer. When we classified the patients by these factors, the group with three factors showed significantly poorer prognosis than the others. Conclusion: Immediate-DIV or OBS did not influence the prognosis in the whole patients. Three prognostic factors that will be judged by urologists easily might be useful for the indication and timing of palliative urinary diversion.
- Subjects
COMPARATIVE studies; MEDICAL records; NEPHROSTOMY; PALLIATIVE treatment; SURGICAL stents; SURVIVAL; TUMORS; URETERIC obstruction; URINARY diversion; GASTROINTESTINAL tumors; HOSPITAL observation units; TREATMENT effectiveness; RETROSPECTIVE studies; ACQUISITION of data methodology; DISEASE complications; SYMPTOMS
- Publication
Journal of Palliative Medicine, 2020, Vol 23, Issue 2, p254
- ISSN
1096-6218
- Publication type
Article
- DOI
10.1089/jpm.2019.0038