Meta-analysis links neoadjuvant chemotherapy to better survival before nephroureterectomy in UTUC

Meta-analysis · Eur Urol Oncol · 2026-10-27. Number 5 in the UrologyWatch Top 5 for October 27, 2026.

Pooling 30 studies (2384 patients, mostly retrospective) on neoadjuvant chemotherapy for upper tract urothelial carcinoma, pathologic complete response occurred in 11% and downstaging in 20%; neoadjuvant chemotherapy was associated with HR 0.56 for overall survival and 0.47 for cancer-specific survival versus upfront surgery.

Why it matters: Adds support for a neoadjuvant chemotherapy approach in UTUC, though most included data are retrospective and immunotherapy evidence remains limited.

Limitation: Only 5 of 30 included studies were prospective or randomized; most data are retrospective and heterogeneous.

Source: Eur Urol Oncol · PubMed 42934012 · DOI 10.1016/j.euo.2026.09.012

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