Median survival time in patients with malignant ureteral obstruction: A systematic review

Malignant ureteral obstruction (MUO) is a common complication of advanced malignancies and is associated with significant morbidity and poor survival. Despite advances in multidisciplinary care and minimally invasive urinary diversion techniques, the prognosis of patients with MUO remains limited. The present systematic review aimed to summarize available evidence on survival time and survival rates in patients with MUO. A comprehensive literature search was performed using PubMed, Google Scholar, ProQuest and the Cochrane Library from inception to January, 2024. Articles that were duplicates, incomplete, or review‑based were excluded from the analysis. A total of 219 records were identified, of which eight studies met the inclusion criteria, encompassing 1,691 patients with MUO. The included studies were predominantly retrospective cohort designs conducted at single‑center institutions. Reported median survival times following MUO diagnosis or urinary diversion ranged from 3 to 16 months. Survival outcomes varied according to oncological background, patient performance status, laboratory parameters and post‑diversion treatment strategies, particularly the receipt of systemic chemotherapy. Across studies, 12‑month survival rates were consistently low, and a substantial proportion of patients succumbed within the first year following diagnosis, highlighting the poor overall prognosis associated with MUO. MUO frequently arises as a consequence of cancer spread to the pelvic region. Given these findings, the involvement of urologists and collaboration across multiple specialties are essential to ensure comprehensive care and to improve outcomes in MUO management.