title: Prognostic factors and outcomes after definitive treatment of female urethral cancer: a population-based analysis.
abstract: OBJECTIVE
  To evaluate the prognostic factors and outcomes for a large observational cohort of female patients with urethral cancer in the Surveillance, Epidemiology, and End Results database.
  
  
  METHODS
  We identified 722 women diagnosed with urethral cancer from 1983 to 2008 in the Surveillance, Epidemiology, and End Results database. Descriptive statistics were used to explore the epidemiology, standard treatment practices, and tumor characteristics. A total of 359 women with nonmetastatic primary urethral cancer were identified for cancer-specific and survival analysis. Kaplan-Meier plots and log-rank tests were performed for each potential covariate. A multivariate Cox proportional hazards model was performed to evaluate age, demographic factors, T stage, nodal status, histologic findings, surgery, and radiotherapy.
  
  
  RESULTS
  The median overall survival time was 42 months (95% confidence interval 35-57), and the 5- and 10-year overall survival rate was 43% and 32%, respectively. The median cancer-specific survival (CSS) time was 78 months, and the 5- and 10-year CSS rate was 53% and 46%, respectively. On multivariate analysis, black race, Stage T3-T4 tumors compared with T1, node-positive disease, nonsquamous histologic features, and advanced age were associated with shortened CSS. Surgery was associated with longer CSS. Black patients presented with a statistically significant greater T stage.
  
  
  CONCLUSIONS
  Advanced age, T stage, node-positive disease, nonsquamous histologic features, and black race were associated with reduced CSS, and surgical resection was associated with longer CSS. We found that black patients present with more advanced tumors and have shorter CSS than white women with urethral cancer.
authors.affiliation: Department of Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 19107, USA.
authors.forename: Colin E
authors.initials: CE
authors.lastname: Champ
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Hegarty
authors.forename: Xinglei
authors.initials: X
authors.lastname: Shen
authors.forename: Mark V
authors.initials: MV
authors.lastname: Mishra
authors.forename: Adam P
authors.initials: AP
authors.lastname: Dicker
authors.forename: Edouard J
authors.initials: EJ
authors.lastname: Trabulsi
authors.forename: Costas D
authors.initials: CD
authors.lastname: Lallas
authors.forename: Leonard G
authors.initials: LG
authors.lastname: Gomella
authors.forename: Terry
authors.initials: T
authors.lastname: Hyslop
authors.forename: Timothy N
authors.initials: TN
authors.lastname: Showalter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D018426:SEER Program; D015996:Survival Rate; D016896:Treatment Outcome; D014523:Urethral Neoplasms / Q000401:mortality* / Q000601:surgery*