Penile-preserving surgery for male distal urethral carcinoma.
OBJECTIVE
To evaluate medium-term outcome data from patients with distal urethral cancers treated with penile-preserving surgery.


METHODS
We analysed prospectively 18 consecutive men referred for the management of urethral carcinoma. All had a specialist review in a supra-regional multidisciplinary team meeting, where the histology findings were reviewed by one pathology consultant. Tumours were staged according to the Tumour-Node-Metastasis classification and the patients offered penile-preserving surgery when tumours were limited to the glanular or penile urethra.


RESULTS
All 18 patients were suitable for penile-preserving surgery; the procedures were: three hypospadias formation with or without topical chemotherapy; four buccal mucosa urethroplasty; three glansectomy and reconstruction; six glansectomy, distal corporectomy, reconstruction and hypospadias formation; two urethrectomy with or with no excision of adjacent tunica albuginea. The mean (median, range) follow-up was 26 (20.5, 9-58) months. There were no local recurrences; four patients with regional nodal disease progressed and of these, two died from metastatic disease, and one died from an unrelated condition.


CONCLUSIONS
Medium-term data show that penile-preserving surgery is a feasible treatment for men with distal urethral carcinoma, providing excellent local control without prejudicing survival; a longer follow-up is needed.
Smith
Yuko
Y
Department of Urology, St George's Hospital, Tooting, London, UK. yuko.smith@btopenworld.com
Hadway
Paul
P
Ahmed
Shwan
S
Perry
Matthew J
MJ
Corbishley
Catherine M
CM
Watkin
Nicholas A
NA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000601:surgery*; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D014523:Urethral Neoplasms / Q000188:drug therapy / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods / Q000592:standards*
D000970:Antineoplastic Agents