Management of primary urethral cancer.
OBJECTIVE
To determine the best therapeutic approach for treatment of patients with urethral cancer according to tumor location and clinical-pathologic stage.


METHODS
A retrospective review of 21 consecutive patients diagnosed with primary urethral carcinoma was performed. Clinical-pathologic staging, treatment modality, and outcome were analyzed.


RESULTS
The overall survival rate was 62%. In patients with clinical Stage Ta-2N0M0 tumors, 8 of 9 patients (89%) are free of disease compared to 5 of 12 patients (42%) with Stage T3-4N0-2M0 tumors (P = 0.03). Best treatment outcome for patients with Stage T3 disease or higher was obtained when multimodality therapy (neoadjuvant chemotherapy and radiation therapy with or without surgery) was administered, with a disease-free survival rate of 60%.


CONCLUSIONS
Clinical-pathologic stage was a strong predictor of disease-free survival rate. For patients with Ta-2N0M0 tumors, multimodality therapy may not be required. Conversely, best treatment outcomes in patients with T3-4N0-2M0 tumors are obtained by administering a multimodal therapy combining chemotherapy and radiation therapy with surgical resection.
Gheiler
E L
EL
Department of Urology, Wayne State University School of Medicine and Barbara Ann Karmanos Cancer Center Institute, Detroit, Michigan, USA.
Tefilli
M V
MV
Tiguert
R
R
de Oliveira
J G
JG
Pontes
J E
JE
Wood
D P
DP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016896:Treatment Outcome; D014523:Urethral Neoplasms / Q000473:pathology / Q000628:therapy*