Malignant ureteric obstruction decompression: how much gain for how much pain? A narrative review. (April 2018)

• Record Type: Journal Article
• Authors: Prentice, Joanna; Amer, Tarik; Tasleem, Ali; Aboumarzouk, Omar
• Is Part Of: Journal of the Royal Society of Medicine. Volume 111:Number 4(2018)
• Page Start: 125
• Page End: 135
• Publication Date: 2018-04
• Subjects: Clinical -- end of life decisions (palliative care) -- oncology -- palliative care -- urological cancer -- urology; Medicine -- Periodicals; Medicine -- Great Britain -- Periodicals; Periodicals; 610.5
• DOI: 10.1177/0141076818766725
• Languages: English
• ISSNs: 0410-0768

Abstract

Over the last thirty years, the management of Malignant Ureteric Obstruction (MUO) has evolved from a single disciplinary decision to a multi-disciplinary approach. Careful consideration must be given to the risks and benefits of decompression of hydronephrosis for an individual patient. There is a lack of consensus of opinion as well as strong evidence to support the decision process. Outcomes that were identified amongst patients undergoing treatment for MUO included prognosis, quality of life (QOL), complications, morbidity and prognostication tools. A total of 63 papers were included. Median survival was 6.4 months in the 53 papers that stated this outcome. Significant predictors to poor outcomes included low serum albumin, hyponatremia, the number of malignancy related events, and performance status of 2 or worse on the European cooperative cancer group. We propose a multi-centre review of outcomes to enable evidence-based consultations for patients and their families.