title: Outcomes and Prognostic Factors of Primary Urethral Cancer.
abstract: OBJECTIVE
  To identify prognostic and treatment factors for primary urethral cancer using a nationwide database.
  
  
  METHODS
  The National Cancer Database was queried for all cases of primary urethral cancer from 2004 to 2013. Patients with other cancer diagnoses, metastasis, or diagnosis on autopsy were excluded. Proportional hazards regression was used to identify independent predictors of overall survival in patients with primary urethral cancer. Because we hypothesized that predictors may covary by sex, we also performed regression analysis stratified by sex.
  
  
  RESULTS
  We identified 1268 men and 869 women with primary urethral cancer. Women tended to have more advanced tumors and adenocarcinoma histology. Median survival for the entire cohort was 49 months (43-55), with 5- and 10-year survival rates of 46% and 31%, respectively. On multivariate analysis, age, race, stage, grade, and Charlson comorbidity index were independent predictors of overall survival. Histology was not a predictor of overall survival in the combined model; however, adenocarcinoma in women increased hazards of death, whereas it decreased hazards of death in men when compared with squamous cell carcinoma.
  
  
  CONCLUSIONS
  Men and women with primary urethral cancer had significant differences in histology, grade, and nodal status. In addition to several expected disease-related factors, black race was associated with increased mortality for patients with primary urethral cancer.
authors.affiliation: Department of Urology, Columbia University Medical Center, New York, NY.
authors.forename: Wilson
authors.initials: W
authors.lastname: Sui
authors.affiliation: Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY.
authors.forename: Arindam
authors.initials: A
authors.lastname: RoyChoudhury
authors.affiliation: Department of Urology, Columbia University Medical Center, New York, NY.
authors.forename: Sven
authors.initials: S
authors.lastname: Wenske
authors.affiliation: Department of Urology, Columbia University Medical Center, New York, NY.
authors.forename: Guarionex J
authors.initials: GJ
authors.lastname: Decastro
authors.affiliation: Department of Urology, Columbia University Medical Center, New York, NY.
authors.forename: James M
authors.initials: JM
authors.lastname: McKiernan
authors.affiliation: Department of Urology, Columbia University Medical Center, New York, NY. Electronic address: cba2125@cumc.columbia.edu.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Anderson
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000208:ethnology / Q000401:mortality* / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012737:Sex Factors; D012959:Socioeconomic Factors; D015996:Survival Rate; D014481:United States; D014523:Urethral Neoplasms / Q000208:ethnology / Q000401:mortality* / Q000473:pathology*