BACKGROUND: There is a lack of consensus regarding the prognostic significance of ureteral versus renal pelvic upper tract urothelial carcinoma (UTUC). OBJECTIVE: To investigate the association of tumor location on outcomes for UTUC in an international cohort of patients managed by radical nephroureterectomy (RNU). DESIGN, SETTING, AND PARTICIPANTS: A retrospective review of institutional databases from 10 institutions worldwide identified patients with UTUC. INTERVENTION: The 1249 patients in the study underwent RNU with ipsilateral bladder cuff resection between 1987 and 2007. MEASUREMENTS: Data accrued included age, gender, race, surgical approach (open vs laparoscopic), tumor pathology (stage, grade, lymph node status), tumor location, use of perioperative chemotherapy, prior endoscopic therapy, urothelial carcinoma recurrence, and mortality from urothelial carcinoma. Tumor location was divided into two groups (renal pelvis and ureter) based on the location of the dominant tumor. RESULTS AND LIMITATIONS: The 5-yr recurrence-free and cancer-specific survival estimates for this cohort were 75% and 78%, respectively. On multivariate analysis, only pathologic tumor (pT) classification (p