多项研究表明，与单纯手术相比，新辅助化疗和辅助化疗在上尿路移行细胞癌患者中具有显著的疗效。然而，目前尚无任何临床试验证实新辅助化疗或辅助化疗在围手术期结果方面的优越性。我们进行了回顾性分析，包括164例接受根治性肾输尿管切除术并接受围手术化疗的上尿路移行细胞癌患者。其中，65例（39.6%）接受新辅助化疗，99例（60.4%）接受辅助化疗。采用Kaplan-Meier方法计算了无复发生存率和癌特异性生存率。此外，我们进行了Cox回归分析，评估了无复发生存率和癌特异性生存率的风险因素。新辅助化疗组中病理分期下降37％。然而，在该队列中未观察到病理完全缓解。Kaplan-Meier曲线显示，接受辅助化疗的患者无论在无复发生存率还是癌特异性生存率方面都显著降低。多变量Cox回归分析表明，接受辅助化疗的患者与较低的无复发生存率和癌特异性生存率显著相关。本研究提示，在高风险上尿路移行细胞癌患者中，新辅助化疗可能比辅助化疗更有效。© 2023作者。由牛津大学出版社出版。版权所有。如需获得权限，请发送电子邮件至：journals.permissions@oup.com。

Multiple studies have demonstrated the effectiveness of neoadjuvant chemotherapy and adjuvant chemotherapy in patients with upper tract urothelial carcinoma compared with surgery alone. However, no clinical trial has established the superiority of neoadjuvant chemotherapy or adjuvant chemotherapy in terms of perioperative outcomes.We conducted a retrospective analysis encompassing 164 upper tract urothelial carcinoma patients who underwent radical nephroureterectomy and received perioperative chemotherapy. Of these patients, 65 (39.6%) and 99 (60.4%) received neoadjuvant chemotherapy and adjuvant chemotherapy, respectively. Recurrence-free survival and cancer-specific survival were computed using the Kaplan-Meier method. Additionally, we conducted Cox regression analyses to evaluate the risk factors for recurrence-free survival and cancer-specific survival.Pathological downstaging was seen in 37% of the neoadjuvant chemotherapy group. However, no pathological complete response was observed in this cohort. The Kaplan-Meier curves demonstrated significantly lower recurrence-free survival and cancer-specific survival in patients who received adjuvant chemotherapy. Multivariate Cox regression analysis revealed patients treated with adjuvant chemotherapy exhibited a marked association with inferior recurrence-free survival and cancer-specific survival.Our study has suggested that neoadjuvant chemotherapy would be more effective in high-risk upper tract urothelial carcinoma patients compared with adjuvant chemotherapy.© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.