We surveyed 34 patients of transitional cell carcinoma of the upper urinary tract treated with nephroureterectomy with excision of a cuff of bladder or combined with regional lymphadenectomy to investigate the mode of lymph node metastasis and post-operative recurrence. In 8 of 14 patients undergoing nephroureterectomy with excision of a cuff of bladder combined with regional lymphadenectomy, lymph node metastasis was histologically confirmed in the neighbouring lymph node, of which 2 patients showed the skipped lymph node metastasis simultaneously. Subsequent bladder cancer developed in 12 out of 34 patients (35.3%) and the primary tumor showed papillary growth in all patients except for one patient which showed non-papillary growth, but with pR1. During the observation period with the mean of 9.4 months, remote metastases in other organs were detected in 6 patients with invasive primary tumor more than pT2.