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To determine the incidence and risk factors of intravesical recurrence in patients with primary upper urinary tract urothelial caners after hand assisted retroperitoneoscopic nephroureterectomy.We retrospectively reviewed our 220 patients with upper urinary tract TCC undergone hand assisted retroperitoneoscopic nephroureterectomy between December 2004 and July 2009 at National Cheng Kung University Hospital.We review the demographic, clinical, surgical, and pathological data to determine what clinical and pathologic variables significantly affected the initial intravesical recurrence of cancer.We also studied the location of intravesical recurrence related to the original ureterovesical junction, risk of intramual ureteral recurrence in the presence of residual orifice and clinical outcomes of patients having cancer recurrence in the bladder.