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INcidence of malignant ureteric obStruction In patienTs with non-organ confined abdominopElvic malignancy (INSITE MUO)
Project Summary

Urologists and Interventional Radiologists are frequently referred cancer patients with hydronephrosis secondary to malignant ureteric obstruction (MUO). This causes renal failure, severe pain, urosepsis, and may prevent cancer treatment or threaten life. Percutaneous nephrostomy (PCN) insertion, and ureteric stenting (US) can relieve obstruction. Both require regular tube exchanges in hospital, usually for the patient's remaining lifetime. 

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Unlike other oncology emergencies such as metastatic spinal cord compression, no standardised care pathway exists for MUO and there is geographical variation in management approach. In addition, little is known about the MUO patients that do not receive intervention. The incidence of MUO is poorly captured, particularly across different advanced malignancies. 

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INSITE MUO seeks to retrospectively capture and analyse ALL patients with MUO irrespective of management option, and identify a population at risk using CT scan reports to determine the incidence of MUO in non-organ confined abdominopelvic malignancies.

Project Status

Recruitment for INSITE MUO is Closed. 

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A huge thanks to all of the collaborators who have signed up.

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The details

Study design

Muticentre retrospective service evaluation 

Inclusion Criteria

Adult Patients with malignancy  within the abdomen and pelvis on CT during 2 x 2 week periods 

Exclusion criteria

Patients under 18.

Sample size

39,379

Follow-up Duration

Patients under 18. Benign cause MUO

1 year

Planned Study Period

Not calculated

June-August 2024

Primary objective

Incidence of malignant ureteric obstruction in patients with abdominopelvic malignancy

How to contact us

Team and funding

Principal Investigators

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  • Dr Oliver Llewellyn MRCS FRCR is an Interventional Radiology ST5 in Glasgow and RCR Kodak Research Fellow.

  • Mr James Blackmur PhD FRCSEd(Urol) is a post-CCT Senior Clinical Fellow in Urology at Addenbrooke’s Hospital, Cambridge.

  • Mr Jonathan Aning FRCS(Urol) DM BM BS BMedSci is a Consultant Urologist at Bristol Urological Institute and Honorary Associate Professor at Bristol University.

  • Dr Tristan Barrett FRCR MD is an Associate Professor of Radiology and Consultant Radiologist at Addenbrookes Hospital, Cambridge.

  • Mr Alexander Laird PhD FRCSEd(Urol) is a Consultant Urologist and Honorary Clinical Lecturer at The University of Edinburgh.

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Ethics and Funding

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​The INSITE MUO protocol has been reviewed by the NHS research ethics committee in Edinburgh and has been designated as a service evaluation not requiring any further ethical approvals.​

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  • This study is sponsored by ACCORD (NHS Lothian & University of Edinburgh)

  • This study is funded by the Royal College of Radiologists.

  • This study has received research ethics committee opinion (Ref 23/NRS/0070)

  • This study has received HRA approval in England & Wales (Protocol no AC23185)

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