Sex-related differences in clinicopathological features and survival of patients with primary urethral carcinoma: a population-based study

Wei, Yong; Wu, Yupeng; Xu, Ning; Li, Xiaodong; Chen, Shao‐Hao; Cai, Hai; Zheng, Qing‐Shui; Xue, Xue-Yi

doi:10.2147/ott.s139252

Cited by 14 publications

(14 citation statements)

References 23 publications

(39 reference statements)

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“…In this study, there was no difference in prognosis between men and women, which has also been confirmed in other studies 13,14. However, although SCC is most common among women,15 studies have reported that women’s prognosis is poorer than that of men in AC 13.…”

Section: Discussionsupporting

confidence: 90%

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Prognosis of rare pathological primary urethral carcinoma

Abudurexiti¹,

Wang²,

Shao³

et al. 2018

CMAR

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PurposeUrethral carcinoma (UC), as a rare tumor, is not widely studied. There have been no systematic studies of rare pathological types of UC. We conducted this study to further investigate rare pathological types of primary urethral carcinoma (PUC).Materials and methodsWe used the population-based Surveillance, Epidemiology, and End Results (SEER) database to evaluate prognostic factors in rare pathological types of PUC. From 1978 to 2015, 2,651 and 257 cases were identified in the SEER database as common and rare pathological types of PUC, respectively. Overall and cancer-specific survival (CSS) times were computed using the Kaplan–Meier method, and the Cox proportional hazards analysis was used to evaluate patient age at diagnosis, gender, race, and TNM stage.ResultsThe median overall survival (OS) rates were 36 and 59 months for rare and common pathological groups, respectively, and their respective 10-year OS rates were 31.9% and 42.4%, respectively. The median CSS rate was 61 months for the rare pathological group. Through multivariate analysis, it was found that age, race, T stage, and M stage were independent prognostic risk factors for rare pathological type of urethral cancer. In the age group, the HR ratio of patients aged older than 60 years and younger or equal to 60 years was 2.778 (P<0.001). The HR ratio of other races to Whites was 1.444 (P=0.040). In TNM staging, the HR ratio between T3–T4 and Ta–T2 was 2.386 (P=0.046), and the HR value of M1 and M0 was 5.847 (P<0.001).ConclusionAge, race, T stage, and M stage were predictive of OS and CSS in rare pathological PUC.

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Section: Discussionsupporting

confidence: 90%

“…However, although SCC is most common among women,15 studies have reported that women’s prognosis is poorer than that of men in AC 13. There have also been reports of higher clinical stages of AC in Black women than men 14. In the USA, the onset time of male and female urethral cancer is approximately 60 years 15,16.…”

Section: Discussionmentioning

confidence: 99%

Prognosis of rare pathological primary urethral carcinoma

Abudurexiti¹,

Wang²,

Shao³

et al. 2018

CMAR

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“…A positive effect of the combination of surgery and RT compared with monotherapy has been reported previously [41]. While surgery alone was associated with better CSS than RT alone in the SEER studies of Rabbani [17] (p = 0.018) and Champ et al [12] (p = 0.001), Wei et al [19] found surgery to be an independent factor for better OS and CSS in women treated with RT (p = 0.003). Furthermore, Son et al [18] reported that in the NCDB cohort, the absence of local therapy (surgery and/or RT) was an independent factor for worse OS (no p value reported).…”

Section: Influence Of Rt On Survival Outcomesmentioning

confidence: 64%

“…A total of 12 studies with 7853 patients were included according to the statement of Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) protocols ( Fig. 1, and Tables 1 and 2) [11][12][13][14][15][16][17][18][19][20]. Two large multicentric studies reported on the same cohort [14,15].…”

Section: Evidence Synthesismentioning

confidence: 99%

Current Disease Management of Primary Urethral Carcinoma

Janisch

Abufaraj

Fajković

et al. 2019

European Urology Focus

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Context: Primary urethral cancer (PUC) is a rare cancer entity. Owing to the low incidence of this malignancy, the main body of literature consists mainly of case reports, making evidencebased management recommendations difficult. Objective: To review reported disease management strategies of PUC and their impact on oncological outcomes. Evidence acquisition: A systematic research was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement using Medline, Scopus, and Web of Science, to find studies of the past 10 yr including !20 patients, and investigating treatment strategies and their impact on outcomes of the three most frequent histologies: urothelial carcinoma, adenocarcinoma, and squamous cell carcinoma. Evidence synthesis: In localized PUC, penis-sparing surgery can be performed in males, while in females, complete urethrectomy with surrounding tissue is advised to minimize recurrence due to positive margins. Radiotherapy (RT) has worse survival and recurrence rates, as well as more adverse effects, than surgery, limiting its use in genital-preserving therapy. Locally advanced PUC should be treated with multimodal therapy, as monotherapies result in inferior recurrence and survival rates. Extent of surgery is still undecided, favoring radical cyst (oprostat)ectomy with total urethrectomy (RCU). Lymph node involvement is a predictor of survival, highlighting the role of lymph node dissection for disease control and staging. RT can improve survival in combination with surgery and/or chemotherapy (CHT). Neoadjuvant platinum-based CHT can improve overall and recurrence-free survival. At recurrence, salvage therapy with surgery and/or CHT can improve survival. Superficial urothelial carcinoma of the prostatic urethra can be treated with transurethral resection. Stromal invasion often features concomitant bladder cancer with a poor prognosis and requires RCU with or without systemic preoperative CHT. Conclusions: PUC is a rare malignancy with an often poor natural course, requiring a stageand gender-specific risk-based treatment strategy. The role of systematic perioperative CHT and the extent of surgery are becoming more important. Patient summary: In this review, we looked at the treatment options for primary urethral cancer. We found that while an organ-confined disease can be managed with local resection, growth beyond the organ border makes a combination of different treatment modalities, such as surgery and systematic chemotherapy, necessary to improve outcomes.

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“…These tumours have an aggressive natural history, with reported 5‐year overall survival rates of 32–54% [2,3,7,8]. Patient and tumour characteristics associated with oncological outcome include sex, age, tumour location, stage and nodal status [2,3,5,9,10].…”

Section: Introductionmentioning

confidence: 99%

Primary urethral cancer: treatment patterns and associated outcomes

et al. 2020

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Objectives To evaluate treatment patterns and associated outcomes of patients with urethral cancer. Patients and Methods After obtaining institutional review board approval we identified 165 patients treated for primary urethral cancer between 1956 and 2017. Treatment included monotherapy (surgery or radiation), dual therapy (surgery+radiation, surgery+chemotherapy, or chemotherapy+radiation) or triple therapy (surgery+radiation+chemotherapy). Rates of different treatments were described by treatment year. The association between treatment type and outcomes was evaluated with multivariable Cox regression models, adjusting for disease characteristics. Results The study cohort included 74 men and 91 women, with a median age of 61 years. Common histologies were squamous cell (36%), urothelial (27%) and adenocarcinoma (25%). At presentation, 72% of patients had invasive disease, 24% had nodal involvement, and 5% had metastases. Treatment included monotherapy (57%), dual therapy (21%), and triple therapy (10%). The use of monotherapy decreased over time, while rates of dual therapy remained consistent, and rates of triple therapy increased. The median follow‐up was 4.7 years. Estimated 5‐year local recurrence‐free, disease‐specific and overall survival were 51%, 48% and 41%, respectively. Monotherapy was associated with decreased local recurrence‐free survival after adjusting for stage, histology, sex and year of treatment (P = 0.017). There was no evidence that treatment type was associated with distant recurrence, cancer‐specific or overall survival. Conclusions We found preliminary evidence that multimodal therapy, more commonly used in recent years, was of benefit in patients with primary urethral cancer. This finding should be confirmed in further studies involving multiple centres because of the low incidence of the disease.

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Sex-related differences in clinicopathological features and survival of patients with primary urethral carcinoma: a population-based study

Cited by 14 publications

References 23 publications

Prognosis of rare pathological primary urethral carcinoma

Prognosis of rare pathological primary urethral carcinoma

Current Disease Management of Primary Urethral Carcinoma

Primary urethral cancer: treatment patterns and associated outcomes

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