Comparing two methods to prevent cancer recurrence after upper tract surgery

After surgery to remove cancer from the upper urinary tract (the kidney and ureter), cancer can sometimes come back in the bladder. This trial is testing whether gemcitabine, a chemotherapy medication, can be placed directly into the bladder during your surgery to help prevent this recurrence. The study compares this approach to continuous flushing of the bladder with sterile water, to see which method works better at keeping cancer from returning.

Up to half of patients who have upper tract cancer surgery develop cancer in their bladder afterward. Doctors think tumor cells may shed during surgery and seed the bladder, so this trial is testing whether the medication can reduce this risk better than water irrigation alone.