Background and purpose: Urethral carcinoma in women is uncommon. This study
was undertaken to evaluate the role of radiotherapy in the treatment of th
ese tumors.
Materials and methods: The hospital records of 34 women with primary urethr
al carcinoma were retrospectively reviewed. There were 15 squamous cell car
cinomas, 13 transitional cell carcinomas, and six adenocarcinomas. The prim
ary tumor was >4 cm in size in eight patients, involved the proximal urethr
a in 19 and extended to adjacent organs in 22. Inguinal or iliac lymphadeno
pathy was present in nine patients. There were eight TNM stage I/II tumors,
11 stage III tumors and 15 stage IV tumors. Radiotherapy was administered
only to the primary tumor in 15 patients, and to the primary tumor and regi
onal lymph nodes in the remaining 19 patients. Brachytherapy with or withou
t external radiation was used to treat the primary tumor in 20 patients.
Results: Tumor recurred in 21 patients. The 7-year actuarial overall and ca
use-specific survivals were 41 and 45%, respectively. Large primary tumor b
ull; and treatment with external beam radiation alone (no brachytherapy) we
re independent adverse prognostic factors for local tumor recurrence. Brach
ytherapy reduced the risk of local recurrence by a factor of 4.2. The benef
icial effect of brachytherapy was most prominently seen in patients with bu
lky primary disease. Large tumor size was the only independent adverse pred
ictor of overall disease recurrence and death from cancer.
Conclusions: Radiotherapy is an effective treatment for carcinoma of the fe
male urethra and preserves normal anatomy and function. Brachytherapy impro
ves local tumor control, possibly as a result of the higher radiation dose
that can safely be delivered. (C) 2000 Elsevier Science Ireland Ltd. All ri
ghts reserved.