Cancer Clinical Trial
Official title:
DECOMPRESS (DECompressing Obstruction of Malignancy: Percutaneous Renal vs Endoscopic Stent)
This research study will compare two procedures commonly used to treat urinary obstruction due to cancer. Sometimes cancer blocks one or both ureters (narrow tubes in the body that carry urine from the kidneys to the bladder). When these ureters become blocked, the body can no longer properly drain urine. This blocking of the ureters is called urinary obstruction, which can lead to kidney problems, infection, and pain. Treatment options for urinary obstruction include ureteral stent placement and percutaneous nephrostomy tube placement. Both treatment options require a doctor to place soft tubes (like a catheter) inside the body to help the ureters properly drain urine. These two treatment options have different success rates, risks, and effects on quality of life. By doing this study, researchers hope to learn which treatment option is best for individuals who develop urinary obstruction because of cancer. Participation in this research will last about 3 months.
Status | Recruiting |
Enrollment | 60 |
Est. completion date | September 1, 2025 |
Est. primary completion date | June 1, 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria - Patients must have unilateral or bilateral hydronephrosis secondary to extrinsic compression by malignancy on cross sectional imaging. - Age =18 years. - Ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria - Anticoagulation that cannot be safely reversed in the peri-procedural time period. - History of severe allergy to contrast media. - Prior stent or nephrostomy in previous 6 months. - Urethral or ureteric stricture disease. - Lower urinary tract structural abnormalities or urinary diversion precluding retrograde ureteral stent placement. - On blood pressure support or clinically unstable. - Pregnant women are excluded from this study because the radiation from either procedure is known to have the potential for teratogenic or abortifacient effects. - Previous renal transplant. - Dialysis |
Country | Name | City | State |
---|---|---|---|
United States | The University of Chicago | Chicago | Illinois |
Lead Sponsor | Collaborator |
---|---|
University of Chicago |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Trial Feasibility (as assessed by number of enrolled and recruited patients) | The feasibility of a definitive randomized trial, specifically to quantify patient willingness to be randomly assigned treatment with retrograde ureteral stent versus percutaneous nephrostomy tube placement for malignant ureteral obstruction. The number of patient eligible and subsequent recruitment rates. Feasibility will be defined as successfully enrolling 50 patients in the 12 month enrollment period. | 3 months | |
Secondary | Rate of Success for Participants Randomized to Percutaneous Nephrostomy vs. Ureteral Stent Placement | The rate of technical success when randomizing patients to percutaneous nephrostomy or ureteral stent placement for managing malignant ureteral obstruction. This rate of technical success will be assessed by:
Decompression failure (defined as any of the following: technical failure of study procedure, stable or worsening hydronephrosis on imaging at 3 months follow up, urosepsis within 3 months of procedure, or need for additional decompression procedure (stent or nephrostomy placement) within 2 months after initial procedure Adverse surgical events (defined as grade =3 Clavien-Dindo classification) Patient reported outcomes at baseline, 7-day, 30-day and 90-day post-procedure using the Brief Pain Inventory, PROMIS Adult Physical Function Short Form (v2.0), and American Urological Association Symptom Score Compliance rate with questionnaires Reasons for non-randomisation, percentage of non-consenting participants who choose nephrostomy vs. retrograde ureteral stenting |
6 months |
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