OBJECTIVE To assess the impact of patient age on outcomes after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). PATIENTS AND METHODS Data were collected on 1453 patients treated with RNU at 13 centres. Pathological slides were reviewed by dedicated genitourinary pathologists according to standardized criteria. Age at RNU was analysed both as a continuous and categorical variable (/=80 years, n = 200). RESULTS Patients aged 70 years were less likely to undergo lymphadenectomy and to receive adjuvant chemotherapy (P 60 years) and cancer-specific survival (CSS; >80 years) after controlling for the effects of standard pathological features (P