Nephroureterectomy With and Without Lymph Node Dissection for Upper Tract Urothelial Cell Carcinoma

Inclusion Criteria:

• Adults > 18 years

• Diagnosis of UTUC as determined by upper tract biopsy (either low or high grade)

• Planned for nephroureterectomy by their urologic surgeon

• Disease that is ≤cT4, N0M0. Participants must have complete TNM staging prior tosurgery. cT disease can be determined by biopsy of the mass (if biopsy was deepenough) or imaging (CT/MRI). cN and cM stage must be determined by preoperativeimaging of the chest, abdomen and pelvis.

• No concomitant muscle-invasive bladder cancer

• Subjects must have the ability to understand and the willingness to sign a writteninformed consent document.

Exclusion Criteria:

• Pathologically enlarged lymph nodes suspicious for metastases which would requirelymph node dissection regardless of trial (>cN0)

• Presence of distant metastases

• Concomitant muscle invasive bladder cancer

• The participant is in a reduced general condition or has a life-threatening disease.

• The participant has a psychiatric disorder that precludes them from understandingthe consent process.

• The patient is pregnant