INSITE MUO (INcidence of malignant ureteric obStruction In patienTs with non-organ confined abdominopElvic malignancy) is a multicentre retrospective study exploring the incidence and management of malignant ureteric obstruction.
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.
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. INSITE MUO seeks to determine the incidence of MUO in non-organ confined abdominopelvic malignancies.
To capture MUO patients, radiology reports from CT scans involving the abdomen and pelvis will be filtered for cancer. 28 days worth of retrospective data will be collected over a period of 2 months. Reports positive for cancer in the abdomen and/or pelvis will be annonymised by local study teams who will keep a document linking anonymisation number to patient identifiable details. Minimal data regarding these cases will then be entered into the REDCap (https://projectredcap.org) central data collection site. Further data regarding MUO cases (approx <10 cases based on pilot) will also be entered.
We are looking for one PI in each centre who is expected to be a post FRCR Radiology SpR or Consultant, and at least one (preferably more than 1) other junior doctor team member (foundation year 1, 2, or FY2+). Larger centres will require a greater number of team members.
Publication will be as a collaborative. Those participating in data collection will be named as collaborators, opportunity for increased involvement and recognition as an author is available for some involved if desired upon discussion and contributed value.
If you are interested in getting involved, please enter your details here: https://forms.gle/b6shT6VSRgZc38co8 or email MUOstudies@gmail.com for more information.
*Nephrostomy involves radiologically-guided insertion of a drain percutaneously into the obstructed kidney, under local anaesthetic. It’s often technically successful but frequently complicated by displacement, leaking, blockage and sepsis, long-term admission, and poor quality of life.
**Ureteric stenting involves a cystoscopically inserted stent, usually under general anaesthetic. Insertion fails more often, and patients experience irritation symptoms. Complications include haematuria, infection, blockage, and longer-term failure.
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 Alexander Laird PhD FRCSEd(Urol) is a Consultant Urologist and Honorary Clinical Lecturer at The University of Edinburgh.
Mr Jonathan Aning FRCS(Urol) DM BM BS BMedSci is a Consultant Urologist at Bristol Urological Institute and Honorary Associate Professor at Bristol University