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World J Urol. 2016 Jan;34(1):97-103. doi: 10.1007/s00345-015-1583-7. Epub 2015 May 17.

Prognostic factors and outcomes in primary urethral cancer: results from the international collaboration on primary urethral carcinoma.

Author information

1
Department of Urology, University of Tübingen, Tübingen, Germany. georgios.gakis@web.de.
2
Department of Urology, University of Michigan, Ann Arbor, MI, USA.
3
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
4
Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
5
Department of Urology, University of Tübingen, Tübingen, Germany.
6
Department of Urology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic.
7
Mansoura Clinic, Urology and Nephrology Center, Mansoura, Egypt.
8
Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
9
Department of Urology, University Hospital Regensburg, Regensburg, Germany.
10
Department of Urology, University Hospital Berne, Berne, Switzerland.
11
USC/Norris Comprehensive Cancer Center, Institute of Urology, Los Angeles, CA, USA.

Abstract

PURPOSE:

To evaluate risk factors for survival in a large international cohort of patients with primary urethral cancer (PUC).

METHODS:

A series of 154 patients (109 men, 45 women) were diagnosed with PUC in ten referral centers between 1993 and 2012. Kaplan-Meier analysis with log-rank test was used to investigate various potential prognostic factors for recurrence-free (RFS) and overall survival (OS). Multivariate models were constructed to evaluate independent risk factors for recurrence and death.

RESULTS:

Median age at definitive treatment was 66 years (IQR 58-76). Histology was urothelial carcinoma in 72 (47 %), squamous cell carcinoma in 46 (30 %), adenocarcinoma in 17 (11 %), and mixed and other histology in 11 (7 %) and nine (6 %), respectively. A high degree of concordance between clinical and pathologic nodal staging (cN+/cN0 vs. pN+/pN0; p < 0.001) was noted. For clinical nodal staging, the corresponding sensitivity, specificity, and overall accuracy for predicting pathologic nodal stage were 92.8, 92.3, and 92.4 %, respectively. In multivariable Cox-regression analysis for patients staged cM0 at initial diagnosis, RFS was significantly associated with clinical nodal stage (p < 0.001), tumor location (p < 0.001), and age (p = 0.001), whereas clinical nodal stage was the only independent predictor for OS (p = 0.026).

CONCLUSIONS:

These data suggest that clinical nodal stage is a critical parameter for outcomes in PUC.

KEYWORDS:

Clinical; Nodal stage; Primary urethral carcinoma; Prognostic; Risk factors; Survival

PMID:
25981402
DOI:
10.1007/s00345-015-1583-7
[Indexed for MEDLINE]

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