Trial reportLancet (London, England)2020
Adjuvant chemotherapy in upper tract urothelial carcinoma (the POUT trial): a phase 3, open-label, randomised controlled trial.
Trial report in Lancet (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 268 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Phase III Randomised Trial of Peri-Operative Chemotherapy Versus sUrveillance in Upper Tract Urothelial Cancer
Development of New Models for the Evaluation of Preclinical Treatment for Urothelial Carcinomas of the Upper Excretory Tract.
Safety and Efficacy of Adjuvant Radioimmunotherapy Compared With Adjuvant Chemotherapy for Upper Tract Urothelial Carcinoma: An Ambispective Cohort Study
Who cites it
268 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Diagnostic performance of radiomics for detecting and characterising upper tract urothelial carcinoma (UTUC): a systematic review.World journal of urology · 2026Pooled it
- The role of MRI in detection and staging of upper urinary tract cancer: a systematic review of the literature.Frontiers in oncology · 2026Pooled it
- SEOM-SOGUG clinical guideline for urothelial cancer (2025).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Guideline
- A Phase 2 Study of Tislelizumab as Neoadjuvant Treatment of Cisplatin-Ineligible High-Risk Upper Tract Urothelial Carcinoma.The Journal of urology · 2025Trial
- Improved Disease-Free Survival With Adjuvant Chemotherapy After Nephroureterectomy for Upper Tract Urothelial Cancer: Final Results of the POUT Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Trial
- Multicenter Phase II Clinical Trial of Gemcitabine and Cisplatin as Neoadjuvant Chemotherapy for Patients With High-Grade Upper Tract Urothelial Carcinoma.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Trial
- Trial
- Adjuvant nivolumab versus placebo following radical surgery for high-risk muscle-invasive urothelial carcinoma: a subgroup analysis of Japanese patients enrolled in the phase 3 CheckMate 274 trial.Japanese journal of clinical oncology · 2023Trial
- Health-related Quality of Life with Adjuvant Nivolumab After Radical Resection for High-risk Muscle-invasive Urothelial Carcinoma: Results from the Phase 3 CheckMate 274 Trial.European urology oncology · 2022Trial
- Primary kidney squamous cell carcinoma, misdiagnosed as xanthogranulomatous pyelonephritis: A case report.Urology case reports · 2026Article
- The Impact of Tumor Size on Therapeutic Decision-Making for Upper Tract Urothelial Carcinoma: A Large-Scale Population Analysis.Annals of surgical oncology · 2026Article
- Real-world perioperative systemic treatment patterns and postoperative mortality in patients with upper tract urothelial carcinoma undergoing radical nephroureterectomy in Japan: WAKKA-UTUC study.International journal of clinical oncology · 2026Article
- Occult pT2-4 disease and postoperative loss of full-dose cisplatin eligibility in CT-staged cT≤1/cN0 upper tract urothelial carcinoma.International urology and nephrology · 2026Article
- Upper Urinary Tract Carcinoma With Primary Small Cell Neuroendocrine Cancer-Case Report and Review of Literature.IJU case reports · 2026Article
- Integrating Molecular Classification Based on FGFR3, KRAS, HRAS, and TP53 Mutation With TNM Staging Modestly Improves Prediction of Prognosis of Upper Tract Urothelial Carcinoma After Surgery.International journal of urology : official journal of the Japanese Urological Association · 2026Article
- Prognostic factors for mortality and recurrence after radical nephroureterectomy for UTUC: a Brazilian cohort study.International urology and nephrology · 2026Article
- Desmoplastic reaction at the invasive front of upper urinary tract urothelial carcinoma: prognostic impact and associations with tumour invasiveness and immune-inflammatory status.Virchows Archiv : an international journal of pathology · 2026Article
- Upper tract urothelial carcinoma mimicking emphysematous pyelonephritis: a diagnostic challenge case report.International journal of surgery case reports · 2026Article
- Stage-Specific Prognostic Impact of Tumor Location in Upper Tract Urothelial Carcinoma: A Propensity Score-Matched Analysis.Annals of surgical oncology · 2026Observational
- Modern management of locally advanced urothelial carcinoma of the upper urinary tract.World journal of urology · 2026Review
208 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
- Commented on by
Authors and funding
24 authors.
Funding
Abstract
backgroundUrothelial carcinomas of the upper urinary tract (UTUCs) are rare, with poorer stage-for-stage prognosis than urothelial carcinomas of the urinary bladder. No international consensus exists on the benefit of adjuvant chemotherapy for patients with UTUCs after nephroureterectomy with curative intent. The POUT (Peri-Operative chemotherapy versus sUrveillance in upper Tract urothelial cancer) trial aimed to assess the efficacy of systemic platinum-based chemotherapy in patients with UTUCs.
methodsWe did a phase 3, open-label, randomised controlled trial at 71 hospitals in the UK. We recruited patients with UTUC after nephroureterectomy staged as either pT2-T4 pN0-N3 M0 or pTany N1-3 M0. We randomly allocated participants centrally (1:1) to either surveillance or four 21-day cycles of chemotherapy, using a minimisation algorithm with a random element. Chemotherapy was either cisplatin (70 mg/m
findingsBetween June 19, 2012, and Nov 8, 2017, we enrolled 261 participants from 57 of 71 open study sites. 132 patients were assigned chemotherapy and 129 surveillance. One participant allocated chemotherapy withdrew consent for data use after randomisation and was excluded from analyses. Adjuvant chemotherapy significantly improved disease-free survival (hazard ratio 0·45, 95% CI 0·30-0·68; p=0·0001) at a median follow-up of 30·3 months (IQR 18·0-47·5). 3-year event-free estimates were 71% (95% CI 61-78) and 46% (36-56) for chemotherapy and surveillance, respectively. 55 (44%) of 126 participants who started chemotherapy had acute grade 3 or worse treatment-emergent adverse events, which accorded with frequently reported events for the chemotherapy regimen. Five (4%) of 129 patients managed by surveillance had acute grade 3 or worse emergent adverse events. No treatment-related deaths were reported.
interpretationGemcitabine-platinum combination chemotherapy initiated within 90 days after nephroureterectomy significantly improved disease-free survival in patients with locally advanced UTUC. Adjuvant platinum-based chemotherapy should be considered a new standard of care after nephroureterectomy for this patient population.
fundingCancer Research UK.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.