Objective
To identify prognostic and treatment factors for primary urethral cancer using a nationwide
database.
Materials and 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.
Conclusion
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.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to UrologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Rare cancers are not so rare: the rare cancer burden in Europe.Eur J Cancer. 2011; 47: 2493-2511
- Incidence of primary urethral carcinoma in the United States.Urology. 2006; 68: 1164-1168
- Incidence and survival of rare urogenital cancers in Europe.Eur J Cancer. 2012; 48: 456-464
- A high association of oncogenic human papillomaviruses with carcinomas of the female urethra: polymerase chain reaction-based analysis of multiple histological types.J Urol. 1994; 151: 49-53
- Urethral diverticular carcinoma.Cancer. 1992; 70: 665-670
- Oncogenic human papillomavirus type 16 is associated with squamous cell cancer of the male urethra.Cancer Res. 1992; 52: 5018-5023
- Carcinoma of the male urethra.J Urol. 1967; 98: 365-371
- Survival outcomes and predictive factors for female urethral cancer: long-term experience with Korean patients.J Korean Med Sci. 2015; 30: 1143-1149
- Primary carcinoma of the female urethra: single center experience of 18 cases.Jpn J Clin Oncol. 2005; 35: 84-87
- Male urethral carcinoma: analysis of treatment outcome.Urology. 1999; 53: 1126-1132
- Therapy and prognosis for male anterior urethral carcinoma: an update.Urology. 1994; 43: 506-514
- Retrospective analysis of survival outcomes and the role of cisplatin-based chemotherapy in patients with urethral carcinomas referred to medical oncologists.Urol Oncol. 2013; 31: 1171-1177
- Prognostic factors and outcomes after definitive treatment of female urethral cancer: a population-based analysis.Urology. 2012; 80: 374-382
- Prognostic factors in male urethral cancer.Cancer. 2011; 117: 2426-2434
- EAU guidelines on primary urethral carcinoma.Eur Urol. 2013; 64: 823-830
- Prognostic factors and outcomes in primary urethral cancer: results from the international collaboration on primary urethral carcinoma.World J Urol. 2016; 34: 97-103
- Primary urethral carcinoma in females: an epidemiologic study on demographical factors, histological types, tumour stage and survival.World J Urol. 2012; 31: 147-153
- Racial differences in treatment and outcomes among patients with early stage bladder cancer.Cancer. 2010; 116: 50-56
- Racial variation in the quality of surgical care for bladder cancer.Cancer. 2014; 120: 1018-1025
- Survival of blacks and whites after a cancer diagnosis.JAMA. 2002; 287: 2106-2113
- The National Cancer Database 2013 PUF Data Dictionary.(Available at:) (Accessed January 01, 2016)
- Surgery of the Primary Site Codes.(Available at:) (Accessed January 01, 2016)
- Management of primary urethral cancer.Urology. 1998; 52: 487-493
- Primary carcinoma of the female urethra.J Urol. 1976; 116: 188-192
- Multimodal management of primary adenocarcinoma of the female urethra: about four cases.Cancer Radiother. 2016; 20: 169-175
- Primary carcinoma of male urethra.Urology. 1984; 23: 128-133
- Experience with primary carcinoma of the male urethra.J Urol. 1977; 117: 591-594
- Primary carcinoma of the male urethra.South Med J. 1980; 73: 1003-1005
Article info
Publication history
Published online: October 05, 2016
Accepted:
September 20,
2016
Received:
June 4,
2016
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Institutional review board waiver: AAAQ4259.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
