Introduction and Objectives: Patients presenting with malignant ureteric obstruction often undergo decompression with percutaneous nephrostomy (PCN). In order to better inform patients in deciding whether to progress to PCN we intended to assess factors in our population that may predict outcomes.

Methods: A retrospective review of 276 patients who had a PCN inserted for malignant ureteric obstruction from 2005 to 2011 at our institution was performed. Data on prognostic factors, complications, duration of hospital attendances, Eastern Cooperative Oncology Group (ECOG) performance status at time of PCN insertion and overall survival were gathered. Duration of inpatient stay following PCN insertion, maximum level of analgesia required post PCN and deterioration in cognitive status were used as surrogate markers for quality of life.

Results: Median overall survival was 4 months following PCN insertion. Patients who underwent further treatment following placement of their PCN had a median survival of 6.2 months versus 2.2 months for those who had no additional therapy available. The average percentage of remaining lifespan spent in hospital for all patients was 29.7% (range 0.5% to 100%). Patients with an ECOG performance status of 0 had a median survival of 10 months, falling to 17 days with ECOG-4. This corresponded to an average of 25% remaining life-span spent as a hospital inpatient for ECOG-0 compared to 70% for ECOG-4.

Conclusions: Overall survival following PCN insertion for ureteric malignancy is poor, with lack of further treatment options, established malignancy and inferior ECOG Performance Status being poor prognostic factors. Given the poor prognosis and possible adverse effects on quality of life it is important that patients are fully informed prior to proceeding for PCN. We suggest that patients are fully assessed according to the ECOG Performance scale in order to more fully inform them of likely quality of life that can be expected following PCN insertion in this setting.