Patient autonomy and shared decision making in the management of urethral cancer

Neoadjuvant Radiation with Concurrent 5-FU Resulting in Complete Pathologic Response in Stage IIIB Squamous Cell Carcinoma of the Urethra

“…Surgical consolidation and wide resection are still commonly used after neoadjuvant therapy [6]. It is important to note that surgery is associated with complaints of reduction in the quality of life, reports of dissatisfaction of genital appearance, need for urinary diversion, and interference with daily activities [7].…”

Pathologic Complete Response After Chemoradiation of a Massive Primary Urethral Carcinoma

“…Kieffer et al analyzed quality of life in patients undergoing partial penectomy and lymph node dissection and reported significant issues with orgasm, appearance concerns, life interference, and urinary function 4 . In addition, treating patients with surgery alone has yielded suboptimal results, with a treatment failure rate up to 75%, as demonstrated in a number of case reports 5, 6…”

“…Table 1 summarizes the published clinical experience 15, 16, 17, 18, 19, 20, 21, 22, 23. Serrano et al emphasized that, if patients are given an option of organ preservation with CRT, they are extremely likely to opt for this over surgery because of the reduced morbidity 5 . Current National Comprehensive Cancer Network guidelines recommend CRT for cT3/T4 and cN0-2 disease, with or without consolidative surgery 24…”