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Clinical Outcomes After Urinary Diversion for Malignant Ureteral Obstruction Secondary to Non-urologic Cancer: An Analysis of 778 Cases

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dc.contributor.author이종수-
dc.contributor.author장원식-
dc.contributor.author최영득-
dc.contributor.author함원식-
dc.contributor.author허지은-
dc.contributor.author장원식-
dc.contributor.author최영득-
dc.contributor.author함원식-
dc.contributor.author허지은-
dc.date.accessioned2021-09-29T01:17:12Z-
dc.date.available2021-09-29T01:17:12Z-
dc.date.issued2021-04-
dc.identifier.issn1068-9265-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/184289-
dc.description.abstractBackground: This study investigated patient outcomes after urinary diversion in order to manage malignant ureteral obstruction caused by non-urologic cancers and to evaluate predictive factors for overall survival. Methods: The study retrospectively reviewed patients with non-urologic malignancies who underwent ureteral stenting or percutaneous nephrostomy for ureteral obstruction between 2006 and 2014. The variables for predicting overall survival were identified by Cox regression analysis. Results: The study enrolled 778 patients, including 522 patients who underwent ureteral stenting and 256 patients who underwent percutaneous nephrostomy. Renal function was assessed immediately and then 2 weeks after urinary diversion. The median survival period was 5 months (interquartile range [IQR] 2-12 months). A total of 708 patients died. The patients who received chemotherapy after urinary diversion had a survival gain of 7 months compared with the patients who did not receive subsequent chemotherapy (p < 0.001). The survival rate did not differ between the various types of urinary diversion (p = 0.451). In the multivariate analysis, lower survival rates were significantly associated with male sex; previous chemotherapy without radiotherapy; an increasing number of events related to malignant dissemination; low preoperative hemoglobin (< 10 mg/dL), albumin (< 3 g/dL), and estimated glomerular filtration (< 60 mL/min/1.73 m2) rates; and no subsequent chemotherapy or radiotherapy. Conclusions: In cases of ureteral obstruction caused by non-urologic malignancies, the overall survival was poor. However, the patients who received chemotherapy after urinary diversion had a survival gain of 7 months. Therefore, urinary diversion could be considered to preserve renal function for subsequent chemotherapy, whereas patients with the poor prognostic factors should be presented with the option of no intervention.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherSpringer-
dc.relation.isPartOfANNALS OF SURGICAL ONCOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHHumans-
dc.subject.MESHMale-
dc.subject.MESHNeoplasms* / complications-
dc.subject.MESHNephrostomy, Percutaneous* / adverse effects-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHStents-
dc.subject.MESHUreter*-
dc.subject.MESHUreteral Obstruction* / etiology-
dc.subject.MESHUreteral Obstruction* / surgery-
dc.subject.MESHUrinary Diversion* / adverse effects-
dc.titleClinical Outcomes After Urinary Diversion for Malignant Ureteral Obstruction Secondary to Non-urologic Cancer: An Analysis of 778 Cases-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Urology (비뇨의학교실)-
dc.contributor.googleauthorJi Eun Heo-
dc.contributor.googleauthorDae Young Jeon-
dc.contributor.googleauthorJongsoo Lee-
dc.contributor.googleauthorWon Sik Ham-
dc.contributor.googleauthorYoung Deuk Choi-
dc.contributor.googleauthorWon Sik Jang-
dc.identifier.doi10.1245/s10434-020-09423-4-
dc.contributor.localIdA05500-
dc.contributor.localIdA05268-
dc.contributor.localIdA04111-
dc.contributor.localIdA04337-
dc.contributor.localIdA05531-
dc.contributor.localIdA05268-
dc.contributor.localIdA04111-
dc.contributor.localIdA04337-
dc.contributor.localIdA05531-
dc.relation.journalcodeJ00179-
dc.identifier.eissn1534-4681-
dc.identifier.pmid33389298-
dc.identifier.urlhttps://link.springer.com/article/10.1245%2Fs10434-020-09423-4-
dc.contributor.alternativeNameLee, Jong Soo-
dc.contributor.affiliatedAuthor이종수-
dc.contributor.affiliatedAuthor장원식-
dc.contributor.affiliatedAuthor최영득-
dc.contributor.affiliatedAuthor함원식-
dc.contributor.affiliatedAuthor허지은-
dc.contributor.affiliatedAuthor장원식-
dc.contributor.affiliatedAuthor최영득-
dc.contributor.affiliatedAuthor함원식-
dc.contributor.affiliatedAuthor허지은-
dc.citation.volume28-
dc.citation.number4-
dc.citation.startPage2367-
dc.citation.endPage2373-
dc.identifier.bibliographicCitationANNALS OF SURGICAL ONCOLOGY, Vol.28(4) : 2367-2373, 2021-04-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers

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