Combined Postoperative Radiotherapy With Kidney Sparing Surgery for Locally Advanced High-risk Ureteral Cancer

This study evaluates whether adding radiation therapy after surgery can improve outcomes for patients with high-risk ureteral cancer (cancer of the tube connecting the kidney to the bladder) who had kidney-sparing surgery rather than full removal of the kidney. **You may be eligible if...** - You are 18 years old or older - You have high-risk ureteral cancer (grade 3, multiple tumors, or T2–T4 stage) - You had surgery (either partial removal of the ureter or full removal of the kidney and ureter) - You do not have cancer spread to distant organs or lymph nodes - You have not had pelvic radiation before **You may NOT be eligible if...** - Your cancer has already spread to distant organs or lymph nodes at the time of surgery - Your surgery could not remove all visible cancer (R2 resection) - You have a history of bladder cancer, inflammatory bowel disease, or prior abdominal radiation - You are pregnant or breastfeeding - You have significant heart disease or a bleeding disorder Talk to your doctor to see if this trial is right for you.