Endourology/Urolithiasis Predicting Factors for Stent Failure-Free Survival in Patients With a Malignant Ureteral Obstruction Managed With Ureteral Stents

Purpose: To determine predictive factors for stent failure-free survival in patients treated with a retrograde ureteral stent for a malignant ureteral obstruction. Materials and Methods: We retrospectively reviewed 71 patients who underwent in-sertion of a cystoscopic ureteral stent due to a malignant ureteral obstruction between May 2004 and June 2011. Performance status, type of cancer, hydronephrosis grade, location of the obstruction, presence of bladder invasion, C-reactive protein (CRP), se-rum albumin, and inflammation-based prognostic score (Glasgow prognostic score, GPS) were assessed using a Cox proportional regression hazard model as predicting factors for stent failure. Results: A univariate analysis indicted that hypoalbuminemia (＜3.5 g/dL; hazard ratio [HR], 2.43; 95 % confidence interval [CI], 1.21 to 4.86; p=0.012), elevated CRP (≥1 mg/dL; HR, 4.79; 95 % CI, 2.0 to 11.1; p=0.001), and presence of a distal ureter ob-struction (HR, 3.27; 95 % CI, 1.19 to 8.95; p=0.021) were associated with stent fail-ure-free survival. A multivariate analysis revealed that the presence of a mid and lower ureteral obstruction (HR, 3.27; 95 % CI, 1.19 to 8.95; p=0.007), GPS ≥1 (HR, 7.22; 95