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For patients with muscle-invasive bladder cancer who can safely receive cisplatin-based chemotherapy, neoadjuvant cisplatin-based multiagent chemotherapy has been a standard of care for 30 years based on level 1 evidence of a modest survival benefit. Whether this treatment is also effective for upper tract urothelial cancer (UTUC) is unclear, as this rare cancer is not well studied.
In a multicenter, publicly funded, phase III trial, researchers assessed the efficacy and safety of systemic platinum-based chemotherapy following nephroureterectomy in patients with locally advanced UTUC (staged as either pT2–T4, pN0–N3 M0, or pTany N1–3 M0). During a 5-year period, 261 patients were randomized to standard of care surveillance or four 21-day cyc…