Combined Postoperative Radiotherapy With Kidney Sparing Surgery for Locally Advanced High-risk Ureteral Cancer

Inclusion Criteria:

• 1. Ureteral cancer patients with high-risk factors (high-risk factors define multifocal;G3; T2-4); surgery may be performed with patients undergoing partial terminal ureteralresection or radical nephroureterectomy 2)Age ≥18 years; 3)Completion of abdominopelvic CT 4 weeks before enrollment to exclude distant metastasis and regional lymph node metastasis.

4. Patients did not have other malignant neoplastic diseases in the last 5 years except fornon-melanoma of the skin and ductal carcinoma in situ of the breast; Willing to participatein perfecting the necessary examinations and follow-up for the sake of the study, andwilling to provide written informed consent.

Exclusion Criteria:

• 1. Distant metastasis or retroperitoneal lymph node metastasis (N+) had been detectedat the time of surgery; R2 resection patients; history of bladder cancer; 2) Historyof pelvic and abdominal radiotherapy; history of inflammatory bowel disease; historyof systemic chemotherapy; 3) Pregnant women or breastfeeding women; or women ofchildbearing potential who are not practicing reliable contraception; (4) The presenceof active infections in those with pre-existing or coexisting bleeding disorders 5)clinically significant cardiac disease (e.g., hypertension controlled withmedications, unstable angina, New York Heart Association (NYHA) class ≥II congestiveheart failure, unstable symptomatic arrhythmias, or class ≥II peripheral vasculardisease); 6) Psychological, family, and social factors leading to lack of informedconsent.