A new trial has revealed that chemotherapy after surgery can reduce the risk of cancer of the ureter and renal pelvis returning by half.

In the trial, the largest of its kind, patients given chemotherapy within three months of surgery saw the risk of their cancer coming back or spreading reduced and were much more likely to live cancer free for three years or more.

The data showed that 71% of patients given chemotherapy survived for three years or more after joining the trial without their disease coming back, compared with 46% of patients who were on surveillance.

The researchers say that the results could be "set to change clinical practice around the world" – with chemotherapy being recommended after surgery for all suitable patients with a rare tumour of the urinary system that is large or just starting to spread.

Giving chemotherapy after surgery could "give people with this rare form of cancer years more to spend quality time with their families. I’m hopeful that patients will start benefiting very soon" commented professor Emma Hall, professor of oncology clinical trials at The Institute of Cancer Research.

"Running clinical trials in patients with rare cancers comes with its challenges, including finding enough people to take part – so it’s fantastic to see such clear evidence of patient benefit from this study. It shows how important it is to run studies like this to improve treatment options for patients with rarer forms of cancer."

The researchers have confirmed that they are now working to incorporate the trial results into international clinical practice guidelines, so that chemotherapy after surgery will become the new standard of care.

Next, the team plan to study the benefit of adding immunotherapy or targeted treatment to chemotherapy in this form of the disease.

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