MANAGEMENT OF PRIMARY URETHRAL CANCER

Objectives. To determine the best therapeutic approach for treatment o f patients with urethral cancer according to tumor location and clinic al-pathologic stage. Methods. A retrospective review of 21 consecutive patients diagnosed with primary urethral carcinoma was performed. Cli nical-pathologic staging, treatment modality, and outcome were analyze d. Results. The overall survival rate was 62%. In patients with clinic al Stage Ta-2N0M0 tumors, 8 of 9 patients (89%) are free of disease co mpared to 5 of 12 patients (42%) with Stage T3-4N0-2M0 tumors (P = 0.0 3). Best treatment outcome for patients with Stage T3 disease or highe r was obtained when multimodality therapy (neoadjuvant chemotherapy an d radiation therapy with or without surgery) was administered, with a disease-free survival rate of 60%. Conclusions. Clinical-pathologic st age was a strong predictor of disease-free survival rate. For patients with Ta-2N0M0 tumors, multimodality therapy may not be required. Conv ersely, best treatment outcomes in patients with T3-4N0-2M0 tumors are obtained by administering a multimodal therapy combining chemotherapy and radiation therapy with surgical resection. UROLOGY 52: 487-493, 1 998. (C) 1998, Elsevier Science Inc. All rights reserved.