Survival Outcomes Associated With Female Primary Urethral Carcinoma: Review of a Single Institutional Experience

Peyton, Charles C.; Azizi, Mounsif; Chipollini, Juan; Ercole, Cesar E.; Fishman, Mayer; Gilbert, Scott M.; Juwono, Timothy; Lockhart, Jorge; Poch, Michael; Pow‐Sang, Julio M.; Spiess, Philippe E.; Wiegand, Lucas; Sexton, Wade J.

doi:10.1016/j.clgc.2018.05.012

Cited by 14 publications

(29 citation statements)

References 24 publications

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“…While still underused today, multimodal therapy (MMT), consisting of a combination of surgery, CHT, and/or RT, is probably necessary for most patients with advanced PUC. Peyton et al [16] could not prove significant improvement in OS or RFS for patients treated with MMT compared with those treated with monotherapy (ie, median OS of 36 vs 16 mo and median RFS of 58 vs 16 mo), likely due to its small cohort size. Several smaller studies have reported promising OS of up to 83% after 1 yr of CRT [41].…”

Section: Multimodal Treatmentmentioning

confidence: 93%

“…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%

“…Two large multicentric studies reported on the same cohort [14,15]. Three other studies were of single-center nature [13,16,21]. The rest of the studies investigated cohorts of the Surveillance, Epidemiology, and End Results (SEER) database or of the National Cancer Database (NCDB).…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Similar to bladder cancer [51], perioperative CHT seems to improve oncological survival. Reported alternatives for patients who are unable to receive a platinum-based CHT are rare and consist of mitomycin/5-fluorouracil with or without RT, paclitaxel with or without gemcitabine, carmustin/interleukin-2, or dacarbazine [14,16]. Mitomycin and 5-fluorouracil in combination with concurrent RT showed promising results, with more than half of the patients being disease free after 5 yr [48].…”

Section: Influence Of Systemic Cht On Survival Outcomesmentioning

confidence: 99%

“…The EAU guidelines suggest RT or surgery, while the NCCN considers systemic (mono)therapy as well [22,23]. Peyton et al [16] reported no difference in OS between patients presenting with metastasis and those who experienced disease recurrence treated with a salvage therapy (p = 0.56).…”

Section: Therapy For Recurrent Pucmentioning

confidence: 99%

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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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Section: Multimodal Treatmentmentioning

confidence: 93%

Section: Evidence Synthesismentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

Section: Influence Of Systemic Cht On Survival Outcomesmentioning

confidence: 99%

Section: Therapy For Recurrent Pucmentioning

confidence: 99%

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Current Disease Management of Primary Urethral Carcinoma

Janisch

Abufaraj

Fajković

et al. 2019

European Urology Focus

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Clinical features and oncological outcomes of primary female urethral cancer

Lee

et al. 2022

Journal of Surgical Oncology

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Investigation of the clinical features and treatment outcomes of primary female urethral cancer (FUC) at a single institution. Materials and Methods: We retrospectively reviewed 32 FUC patients during 1997-2017. We investigated preoperative risk factors predicting overall (overall survival [OS]) and recurrence-free survival (RFS) and reviewed clinical features, treatment modality, and oncologic outcomes according to pathology. The median follow-up duration and age was 56 months (range: 4-229) and 61 years (range: 15-82), respectively.Results: The median OS and RFS were 70 and 16 months, respectively. A total of 19 (59.4%) patients received systemic chemotherapy, including 14 (43.8%) who received radiation therapy. Further, 22 patients (68.8%) underwent surgery. On univariate analysis, >T2, N+, and tumor size ≥3 cm were associated with poorer OS. There were 15 cases of distant metastasis and five local recurrences.Outcomes were poorest in adenocarcinoma (AC), moderate in clear cell carcinoma and transitional cell carcinoma, and best in squamous cell carcinoma (SCC). Conclusion:Female urethral lesions should be carefully examined to exclude FUC.Distal urethral SCC was responsive to surgical excision, but proximal urethral AC had poor oncological outcome even after extensive treatment. Due to the heterogeneity and poor prognosis of FUC, multimodal treatment is mandatory.

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A brief review on the diagnostic and therapeutic principles of primary urethral cancer

Zhu²,

Ye³

2022

Asian Journal of Urology

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Survival Outcomes Associated With Female Primary Urethral Carcinoma: Review of a Single Institutional Experience

Cited by 14 publications

References 24 publications

Current Disease Management of Primary Urethral Carcinoma

Current Disease Management of Primary Urethral Carcinoma

Clinical features and oncological outcomes of primary female urethral cancer

A brief review on the diagnostic and therapeutic principles of primary urethral cancer

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