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Viprakasit DP et al. - The classic open approach for distal ureter removal is most comparable to the established principles of open oncologic surgery and simultaneously allows for intact en bloc specimen removal. Regardless of technique used, minimal disruption of the urinary tract should be maintained to decrease the risk of recurrences and port-site metastases. The role of routine lymphadenectomy and the utilization of robotic assistance in upper urinary tract TCC are still to be determined. Long-term studies with prospective, randomized trials are necessary to fully evaluate the outcomes of LNU in the management of this aggressive disease.

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