You have accessJournal of UrologyStone Disease: Surgical Therapy II1 Apr 2017PD21-10 ACTIVE STONE REMOVAL CAN PREVENT UROLITHIASIS-RELATED DEATHS IN PATIENTS WITH POOR PERFORMANCE STATUS. Shimpei Yamashita, Yasuo Kohjimoto, Takashi Iguchi, Akinori Iba, and Isao Hara Shimpei YamashitaShimpei Yamashita More articles by this author , Yasuo KohjimotoYasuo Kohjimoto More articles by this author , Takashi IguchiTakashi Iguchi More articles by this author , Akinori IbaAkinori Iba More articles by this author , and Isao HaraIsao Hara More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1048AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Controversies exist as to whether active stone removal should be performed in patients with poor performance status (PS) because of their short life expectancy and perioperative risks. The purpose of the present study was to clarify whether stone removal for patients with poor PS improves their prognosis. METHODS We retrospectively reviewed the charts of 81 patients with poor PS (Eastern Cooperative Oncology Group PS 3 or 4) treated for upper urinary tract stones from January 2009 to March 2016. Seven patients who experienced spontaneous stone expulsion were excluded and 74 patients were enrolled in this study. Patients were classified into operation group and non-operation group based on the presence of active stone removal. We defined stone-specific survival (SSS), and compared overall survival (OS) and SSS between two groups by Kaplan-Meier method/log-rank test. In addition, univariate and multivariate analyses of OS and SSS were performed using Cox proportional hazards model. RESULTS A total of 52 patients (70.3%) received active stone removal (operation group) by either ESWL (n=6), ureteroscopy (n=39), percutaneous nephrolithotomy (n=6) or nephrectomy (n=1). Overall stone free-rate was 78.8% and perioperative complication was observed in 9 patients (17.3%). While, 22 patients (29.7%) underwent conservative treatment (non-operation group). Operation and non-operation groups showed two-year OS rates of 88.0% and 38.4%, respectively (p<0.01), and two-year SSS rates of 100% and 61.3%, respectively (p<0.01) (Figure). On multivariate analysis, stone removal was not significant, but was considered possible favorable predictor for OS (HR 0.43, 95% CI 0.16 – 1.09) after adjustment for factors including age and Charlson comorbidity index. Moreover, stone removal was only independent predictor for SSS (HR 0.06, 95% CI 0.00 – 0.43) (Table). CONCLUSIONS Active stone removal could prevent stone-related deaths, possibly leading to prolonged overall survival in patients with poor PS. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e439-e440 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Shimpei Yamashita More articles by this author Yasuo Kohjimoto More articles by this author Takashi Iguchi More articles by this author Akinori Iba More articles by this author Isao Hara More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...