BACKGROUND: @entity189 of the upper urinary tract (UUT-UC) was a rare, aggressive @entity5 with a propensity for multifocality, local recurrence, and @entity3 . High-risk @entity1 had poor outcomes. Because of the rarity of these @entity5 , randomized clinical trials and data regarding adjuvant chemotherapy in locally advanced @entity5 are currently unavailable. Our objective was to assess the effect of adjuvant chemotherapy and the impact of potential prognostic factors on survival in high-risk, postsurgical UUT-UC @entity1 . METHODS: Using a multi-institutional, international retrospective database, identified were 627 @entity1 with high risk UUT-UCs (pT3N0, pT4N0 and/or N+ and/or M+) who underwent surgical removal. Only @entity1 who received adjuvant chemotherapy were included. RESULTS: Overall, 140 @entity1 (22.6%) with a median age of 67 years were included. The median follow-up was 22.5 months. The 5-year, overall survival for the entire cohort was 43%, the 5-year recurrence-free survival was 54%, and @entity3 -free survival was 53% at 5 years. Positive surgical margins were an independent prognostic factor for recurrence (P = .06), @entity5 -specific mortality (P = .05), and overall mortality (P = .02) of any cause. Adjuvant chemotherapy was not linked with overall or @entity5 -specific survival in @entity1 with high risk disease (adjuvant chemotherapy [n = 140] vs no treatment [n = 487]) (P >.5). CONCLUSIONS: Adjuvant postoperative chemotherapy did not offer any significant benefit to overall survival in our population. Additional data were necessary, and studies enrolling @entity1 at high risk in clinical trials investigating neoadjuvant chemotherapy in conjunction with chemotherapy should have been highly encouraged.

Outcomes after adjuvant chemotherapy in the treatment of high-risk XXXX of the upper urinary tract (UUT-UC): results from a large multicenter collaborative study.

@entity5 :: ('MESH:D009369', 'Disease') :: ['cancer', 'urologic cancer', 'tumors'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity189 :: ('MESH:D002277', 'Disease') :: ['Urothelial carcinoma'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis']
@entity189 :: (MESH:D002277,Disease) :: ['urothelial carcinoma']
