For a patient who is cisplatin-eligible with localized, high-grade upper tract urothelial carcinoma, but no muscularis propria seen on biopsy, what is your approach?  

The risk of clinical under-staging is notorious in UTUC; therefore, we aim to maximize control of disease and address the meaningful risk of micro-metastasis. In that context and outside clinical trial option, we favor the use of neoadjuvant cisplatin-based chemotherapy using either dose dense MVAC ...