Would you offer neoadjuvant chemotherapy for a patient with low-grade upper tract/renal pelvis urothelial carcinoma with concurrent bladder drop-metastasis?   

This question has several aspects. How commonly does a low-grade urothelial tumor metastasize? Is the described lesion in bladder truly a drop metastasis from upper tract? How can concurrent lesions in upper urinary tract and bladder be approached?Underestimation of staging and grading is a problem ...