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Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,536
Online ISSN 1827-1758
Shingo KAWANO 1, Yoshinobu KOMAI 2, Junichiro ISHIOKA 4, Yasuyuki SAKAI 2, Nozomu FUSE 3, Masaaki ITO 1, Kazunori KIHARA 4, Norio SAITO 1
1 Department of Colorectal Surgery, National Cancer Center Hospital East, Chiba, Japan; 2 Department of Urology, National Cancer Center Hospital East, Chiba, Japan; 3 Department of Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan; 4 Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
BACKGROUND: The aim of this study was to determine risk factors for survival after retrograde placement of ureteral stents and develop a prognostic model for advanced gastrointestinal tract (GIT: esophagus, stomach, colon and rectum) cancer patients.
METHODS: We examined the clinical records of 122 patients who underwent retrograde placement of a ureteral stent against malignant extrinsic ureteral obstruction. A prediction model for survival after stenting was developed. We compared its clinical usefulness with our previous model based on the results from nephrostomy cases by decision curve analysis.
RESULTS: Median follow-up period was 201 days (8-1490) and 97 deaths occurred. The 1-year survival rate in this cohort was 29%. Based on multivariate analysis, primary site of colon origin, absence of retroperitoneal lymph node metastasis and serum albumin >3g/dL were significantly associated with a prolonged survival time. To develop a prognostic model, we divided the patients into 3 risk groups of favorable: 0-1 factors (N.=53), intermediate: 2 risk factors (N.=54), and poor: 3 risk factors (N.=15). There were significant differences in the survival profiles of these 3 risk groups (P<0.0001). Decision curve analyses revealed that the current model has a superior net benefit than our previous model for most of the examined probabilities.
CONCLUSIONS: We have developed a novel prognostic model for GIT cancer patients who were treated with retrograde placement of a ureteral stent. The current model should help urologists and medical oncologists to predict survival in cases of malignant extrinsic ureteral obstruction.