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Objective: To compare the prognosis of locally advanced upper tract urothelial carcinoma(UTUC)and bladder tumor(BT)in patients treated with radical surgeries.Methods: We retrospectively reviewed records on 228 consecutive UTUC patients and 174 consecutive BT patients between 2000 and 2012,both with high-stage diseases.Overall and cancer-specific survival was compared using the Kaplan-Meier method.The values of prognostic factors were evaluated by Cox regression analysis.Results: No difference was observed in age and tumor size between the two groups.The UTUC group had significantly more frequent hydronephrosis than the BT group(48.2%vs.1.1%,P=0.000).However,the UTUC group showed significantly less frequent high grade(92.1%vs.98.9%,P=0.002),muhifocality(27.2%vs.53.4%,P=0.000)and lymph nodal involvement(19.3%vs.32.8%,P=0.002)than the BT group.UTUC had statistically better 5-year cancer-specific survival rate(61.0%vs.49.8%,P=0.008)and overall survival rate(58.3%vs.37.4%,P<0.001)than BT.In multivariate analysis,tumor location(HR =0.553),multifocality(HR =0.717),lymph node status(HR=1.920)and hydronephrosis(HR =1.673)were independent risk factors of cancer-specific death.Multivariate analysis revealed that tumor location(HR =0.407),lymph node status(HR =1.651)and hydronephrosis(HR =1.577)were independent risk factors of overall death.Conclusions: Our data suggest that locally invasive UC behaves differently in the upper and lower urinary tracts.UTUC has a better prognosis than BT when stage and grade are considered simultaneously.Lymph node involvement has severe influences on clinical outcomes of urothelial carcinoma which is consistent with other previous studies.