title: Management of primary urethral cancer.
abstract: 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.
authors.affiliation: Department of Urology, Wayne State University School of Medicine and Barbara Ann Karmanos Cancer Center Institute, Detroit, Michigan, USA.
authors.forename: E L
authors.initials: EL
authors.lastname: Gheiler
authors.forename: M V
authors.initials: MV
authors.lastname: Tefilli
authors.forename: R
authors.initials: R
authors.lastname: Tiguert
authors.forename: J G
authors.initials: JG
authors.lastname: de Oliveira
authors.forename: J E
authors.initials: JE
authors.lastname: Pontes
authors.forename: D P
authors.initials: DP
authors.lastname: Wood
mesh_terms: 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*