
The study externally validated the tetrafecta and pentafecta frameworks in assessing the quality of radical nephroureterectomy (RNU) for localized upper tract urothelial carcinoma (UTUC). The frameworks correlate with improved oncological outcomes, such as recurrence-free survival (RFS) and overall survival (OS). Pentafecta showed superior prognostic value, particularly for high-risk populations. These frameworks provide a standardized method to evaluate surgical quality and guide clinical decisions.
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