Trauma & Others(구연) (NP-038) 악성종양으로 인한 요관폐색의 요관부목 치료 실패의 예후 울산대학교 의과대학 비뇨기과학교실 채종석, 윤지형, 박명찬, 박재영, 박세준, 박성찬, 문경현, 전상현, 권택민 Purpose: Extrinsic malignant ureteral obstruction can compromise ureteral patency and lead to renal failure. An internal ureteral stent has been used for some time to relieve upper urinary tract obstruction in these patients. Although these treatments are performed frequently, there are many reports of high failure rates of stenting. In these failed stent-change therapy patients, another form of upper urinary diversion such as percutaneous nephrostomy (PCN) should be considered. However, few studies have addressed the outcomes of failed stent-change therapy. Therefore, we performed this study to investigate the treatment outcomes of failed stent-change therapy. Materials and methods: Between January 2002 and December 2017, we retrospectively reviewed 136 consecutive patients who underwent retrograde ureteral stenting and exchanging at least once every 3 months for malignant ureteral obstruction. The factors affecting stent failure were analyzed using a logistic regression model. The failed stent-change therapy patients were divided into 2 groups depending on whether performing PCN. Overall survival (OS) was estimated, and the prognostic value of PCN for overall survival was assessed by using Cox regression models. Results: Among the 136 patients, stent failure occurred in 36 patients (26.5%). Pre-stenting pyuria and post-stenting complications were significant predictors of stent failure. There were 36 stent failures in total, 11 patients performed PCN. The 5 and 10 year OS rates after stent failure were 19.4% and 10.7%, respectively. There was no difference in prognosis according to whether performing PCN (p=0.761). In the multivariate analysis predicting patient OS after stent failure, post-stenting disease progression was only significant factor (p=0.011). Conclusions: Prognosis of failed stent-change therapy for malignant ureteral obstruction was very poor. Another form of upper urinary diversion such as PCN was not helpful. Only the appropriate treatment of the causative disease is thought to help the patient's prognosis. keywords : Ureteral obstruction, ureteral stent, percutaneous nephrostomy