Primary urethral carcinoma: A Surveillance, Epidemiology, and End Results data analysis identifying predictors of cancer-specific survival

Abstract

Objectives:Primary urethral carcinoma (PUC) is rare, accounting for <1% of genitourinary malignancies. Current knowledge regarding is founded upon tertiary care centers reporting their experiences. We aim to identify factors predictive of outcomes using a nationwide registry database.Materials and Methods:The Surveillance, Epidemiology, and End Results-18 registries database was queried for cases of PUC ranging between 2004 and 2010. To identify PUC cases, ICD-O site code C68.0 was used as a filter, hence identifying PUC with histologic subtypes including urothelial carcinoma (UC), squamous cell carcinoma (SCC), and adenocarcinoma (AC). Tumor characteristics were compared using log-rank analysis, and survival outcomes were compared using Cox proportional hazards models.Results:A total of 419 PUC cases were identified, 250 (59.7%) male and 169 (40.3%) female patients. The most common histology in men was UC (134, 53.6%), followed by SCC (87, 34.8%) and AC (29, 11.6%). The most common histology in women was AC (79, 46.7%), followed by SCC (43, 25.4%) and UC (42, 24.9%). Log-rank analysis illustrated significant difference in cancer-specific survival (CSS) for T-stage, N-stage, M-stage, and stage of PUC with all histological variants combined (P < 0.001). Multivariate Cox proportional hazards model demonstrated that stage and age were significant for survival, with a risk ratio of 1.033 (95% confidence interval [CI], 1.020–1.046)/year of increased age (P < 0.001) and 3.71 (95% CI, 2.72–5.05) for patients with regional or distant spread.Conclusions:Knowledge of patient and tumor characteristics that influences survival is paramount in dictating management. The present study illustrates that age and stage are factors significantly associated with CSS in PUC.

Clear cell adenocarcinoma of the prostatic urethra: A case report

“…The most frequent sites of occurrence are the urethra bulb and membranous urethra followed by the pendulum part and prostatic urethra. Histologically, UC, AC, and SCC account for 24.9%, 46.7%, and 25.4% of urethral malignancies in female patients and 53.6%, 11.6%, and 34.8% of urethral malignancies in male patients, respectively . Clear cell carcinoma is categorized as an AC with columnar and mucinous cell carcinoma types …”

“…Histologically, UC, AC, and SCC account for 24.9%, 46.7%, and 25.4% of urethral malignancies in female patients and 53.6%, 11.6%, and 34.8% of urethral malignancies in male patients, respectively. 3 Clear cell carcinoma is categorized as an AC with columnar and mucinous cell carcinoma types. 1,2 CCA is frequently seen in women, and some cases have been reported as diverticulum tumor.…”

Expression of PD‐L1 and CTLA‐4 in female urethral carcinoma

“…Histologically, UC, AC, and SCC account for 24.9%, 46.7%, and 25.4% of urethral malignancies in female patients and 53.6%, 11.6%, and 34.8% of urethral malignancies in male patients, respectively. 1 Although there are no typical symptoms of urethral cancer, and previously reported cases have shown that dysuria and hemorrhage occur in some patients. 2 These symptoms are often seen in healthy adult women, and due to the low incidence of female urethral carcinoma, it is usually difficult to diagnose based on the symptoms.…”

“…Urethral cancer accounts for 0.02% of all malignant diseases in female patients. Histologically, UC, AC, and SCC account for 24.9%, 46.7%, and 25.4% of urethral malignancies in female patients and 53.6%, 11.6%, and 34.8% of urethral malignancies in male patients, respectively . Although there are no typical symptoms of urethral cancer, and previously reported cases have shown that dysuria and hemorrhage occur in some patients .…”

Leptomeningeal Disease as a Rare Complication of Primary Penile Urethral Cancer

“…Primary PUC is a rare genitourinary malignancy arising from the epithelial lining of the urethra [1] and should be differentiated from urothelial cancer arising from the bladder as well as squamous carcinoma arising from the penile glans [2]. Urethral cancer histologically can be adenocarcinoma, squamous, or urothelial, and a retrospective study showed that many of these cancers can have squamous and urothelial histologic features [2].…”