{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T01:51:40Z","timestamp":1791424300823,"version":"4.3.3"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the effect of neoadjuvant chemotherapy (NAC) on pathological response and oncologic outcomes in patients with high\u2010risk upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU) in a real\u2010world multicenter setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed data from 184 patients with high\u2010risk UTUC who underwent RNU across six institutions and were divided into NAC and non\u2010NAC groups. The primary endpoint was pathological downstaging. Secondary endpoints were non\u2010urinary\u2010tract recurrence\u2010free survival (NUT\u2010RFS) and overall survival (OS). We also compared the NAC group with the combined non\u2010NAC and adjuvant chemotherapy (AC) group. Propensity score matching (PSM) was performed to adjust for baseline differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>34.2% and 14.1% of 184 patients (median age, 75\u2009years; men, 70.7%) received NAC and AC, respectively. NAC was not significantly associated with pathological downstaging. On multivariable analysis, positive urine cytology (bladder) was independently associated with a lower likelihood of downstaging, whereas a higher baseline eGFR was independently associated with a higher likelihood of downstaging. Neither NUT\u2010RFS nor OS differed significantly between the NAC and non\u2010NAC groups or between the NAC and non\u2010NAC plus AC groups, either in the overall cohort or after PSM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this real\u2010world cohort, NAC did not significantly improve pathological or survival outcomes in patients with high\u2010risk UTUC. Oncological outcomes did not differ significantly between NAC and AC administered after pathological confirmation of risk, although this comparison is susceptible to selection and guarantee\u2010time bias. Pathology\u2010guided AC may be a reasonable perioperative strategy, but its relative benefit remains uncertain and warrants prospective validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70662","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T01:05:31Z","timestamp":1791421531000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Oncological Outcomes of Neoadjuvant Chemotherapy in High\u2010Risk\n                    <scp>UTUC<\/scp>\n                    : A Multicenter Study"],"prefix":"10.1111","volume":"33","author":[{"given":"Shinpei","family":"Saito","sequence":"first","affiliation":[{"name":"Department of Urology Chiba University Graduate School of Medicine  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8902-7853","authenticated-orcid":false,"given":"Tomokazu","family":"Sazuka","sequence":"additional","affiliation":[{"name":"Department of Urology Chiba University Graduate School of Medicine  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Washino","sequence":"additional","affiliation":[{"name":"Department of Urology Jichi Medical University Saitama Medical Center  Saitama Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1796-7301","authenticated-orcid":false,"given":"Go","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Uro\u2010Oncology Saitama Medical University International Medical Center  Hidaka Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoichi","family":"Nagamoto","sequence":"additional","affiliation":[{"name":"Department of Urology, Saitama Medical Center Saitama Medical University  Kawagoe Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4931-2489","authenticated-orcid":false,"given":"Yuki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Urology Saitama Cancer Center  Ina\u2010machi, Kitaadati\u2010gun Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9297-2664","authenticated-orcid":false,"given":"Akinori","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Department of Urology Dokkyo Medical University Saitama Medical Center  Koshigaya Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangjon","family":"Pae","sequence":"additional","affiliation":[{"name":"Department of Urology Chiba University Graduate School of Medicine  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Urology Chiba University Graduate School of Medicine  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0070-1590","authenticated-orcid":false,"given":"Yasutaka","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Urology Chiba University Graduate School of Medicine  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9456-8814","authenticated-orcid":false,"given":"Yusuke","family":"Imamura","sequence":"additional","affiliation":[{"name":"Department of Urology Chiba University Graduate School of Medicine  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7508-7521","authenticated-orcid":false,"given":"Shinichi","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Urology Chiba University Graduate School of Medicine  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"17","article-title":"Cancer Statistics, 2023","volume":"73","author":"Siegel R. 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M.","year":"2014","journal-title":"Cancer Discovery"},{"key":"e_1_2_10_26_1","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/s00345-026-06191-w","article-title":"Diagnostic Performance of Radiomics for Detecting and Characterising Upper Tract Urothelial Carcinoma (UTUC): A Systematic Review","volume":"44","author":"Bruinsma J.","year":"2026","journal-title":"World Journal of Urology"},{"key":"e_1_2_10_27_1","doi-asserted-by":"crossref","first-page":"1830","DOI":"10.1111\/cas.15334","article-title":"Perioperative Circulating Tumor DNA Enables the Identification of Patients With Poor Prognosis in Upper Tract Urothelial Carcinoma","volume":"113","author":"Nakano K.","year":"2022","journal-title":"Cancer Science"}],"container-title":["International Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iju.70662","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/iju.70662","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iju.70662","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T01:05:36Z","timestamp":1791421536000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iju.70662"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":26,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/iju.70662"],"URL":"https:\/\/doi.org\/10.1111\/iju.70662","archive":["Portico"],"relation":{},"ISSN":["0919-8172","1442-2042"],"issn-type":[{"value":"0919-8172","type":"print"},{"value":"1442-2042","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-06-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70662"}}