(UroToday.com) In this debate, Dr. Tracy Rose presented why adjuvant chemotherapy should be used in upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy. She began with a description of the POUT trial.1 This is a landmark trial, which was a phase 3, open-label prospective randomized-controlled trial conducted at 71 hospitals in the UK. This trial showed that gemcitabine–platinum combination chemotherapy initiated within 90 days after nephroureterectomy significantly improved disease-free survival in patients with locally advanced UTUC. The primary endpoint was disease-free survival. The arms of this trial were mostly well balanced. 64% of the patients were still able to receive cisplatin following surgery.