Clinical outcome of 36 male patients with primary urethral carcinoma: A single center experience

Abstract

Aim : Retrospective analysis of male urethral carcinoma to assess the best therapeutic approach to the management of this tumor. Methods : A review of 36 cases of male urethral carcinoma diagnosed and treated at our center was performed. Clinical features, treatment modality and outcomes were analysed. Results : The overall median survival time was 55.16 months. The 5-year overall and disease-free survival rate for the cohort was 49% and 23%, respectively. The 5-year survival is 67% for low-stage versus 33% for high-stage tumors and is significantly different ( P = 0.001). The survival was 72% for tumors of the distal urethra versus 36% for tumors of the proximal, with a P -value of 0.02. Conclusion : The tumor location and clinicopathological stage were the most important predictors of the disease-free and overall survival. Multimodal approach is necessary for achieving local control especially for proximal and higher stage tumors.

The contemporary management of primary urethral carcinoma

“…In total, 14 out of 17 patients suffered a recurrence and the 5-year survival rate for proximal urethral tumours was 36%, compared with 72% for distal urethral tumours. 31 Dalbagni et al 21 also reported similar 5-year survival rates of 26% and 69%, for proximal and distal urethral cancers, respectively. Christopher et al 37 presented an innovative approach to a patient with a T4 bulbo-membranous tumour whom was reluctant to undergo emasculative surgery.…”

“…Dinney et al 2 achieved good control in tumours arising from the navicular fossa, with either distal urethrectomy or partial penectomy, with no cases of recurrence 2 ; however, 4 out of 11 patients with disease arising from the penile urethra died of recurrent disease. Thyavihally et al 31 report having 58% recurrence free and 72% 5-year survival for 12 patients with distal urethral cancer, treated with partial penectomy (n = 9) and adjuvant radiotherapy, and in two cases adjuvent chemotherapy was also used. Surgery for distal urethral lesions continues to evolve: Current practice aims to preserve penile length, in order to improve both functional and psychological outcomes following surgery.…”

Urethral carcinoma: critical view on contemporary consecutive series

“…In addition, some studies show that the location of the lesion also interferes with the prognosis, being the involvement of the proximal urethra present in more aggressive cases [17]. There are not many studies comparing the different histological types of urethral cancer, and those which discuss this subject are based only on case reports; this happens due to the rarity of this neoplasia.…”

“…In a study of 36 cases, with 36% distal tumors and 64% proximal tumors, being 72% squamous cell carcinoma, 25% transitional cell carcinoma and 3% adenocarcinoma, patients underwent neoadjuvant pelvic radiotherapy and chemotherapy with five-fluorouracil and cisplastin, with extensive surgical resection of tumors, ranging from partial penectomy (distal tumors) to radical cystectomy, radical penectomy and ileal conduit (invasive proximal tumors) [17].…”

Retrospective analysis of survival outcomes and the role of cisplatin-based chemotherapy in patients with urethral carcinomas referred to medical oncologists

“…A subgroup of patients (usually men) with tumors of the anterior urethra have better outcomes, with reported disease-free survival of 52% after a mean follow-up of 50 months [6]. Distal urethral tumors tend to be of low stage, and cure rates of 70% to 90% after local surgical excision and radiation therapy have been reported in some series [7]. Most cases (66%) of PCU, however, involve the proximal urethra, and they tend to be more advanced and are associated with a 5-year disease-free survival rate of only 20% to 30% with surgery alone [7].…”