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.
Written by:
Gakis G, Morgan TM, Efstathiou JA, Keegan KA, Mischinger J, Todenhoefer T, Schubert T, Zaid HB, Hrbacek J, Ali-El-Dein B, Clayman RH, Galland S, Olugbade K Jr, Rink M, Fritsche HM, Burger M, Chang SS, Babjuk M, Thalmann GN, Stenzl A, Daneshmand S. Are you the author?
Department of Urology, University of Tübingen, Tübingen, Germany.
Reference: World J Urol. 2015 May 17. Epub ahead of print.
doi: 10.1007/s00345-015-1583-7
PubMed Abstract
PMID: 25981402