Abstract
Introduction
The treatment landscape in invasive primary carcinoma of the urethra of urothelial
histology closely aligns that of locally advanced urothelial carcinoma of the bladder.
The survival benefit of perioperative chemotherapy for men undergoing radical surgery
for primary urethral urothelial carcinoma (UUC) has not yet been well-elucidated.
Patients and Methods
Using the National Cancer Database (NCDB), we identified men diagnosed with non-metastatic
invasive UUC (T2-4 N0-2 M0) from 2004 to 2016 treated with radical extirpative surgery.
We compared OS between patients who had received peri-operative neoadjuvant (NAC)
or adjuvant (AC) chemotherapy and those who had not using Kaplan-Meier curves and
multivariable Cox proportional hazards regression model.
Results
A total of 191 patients met inclusion criteria. 113 patients (59.2%) did not receive
chemotherapy, while 39 (20.4%) and 39 (20.4%) received NAC and AC, respectively. Median
follow-up was 28.0 months. Upon multivariable analysis, receipt of NAC (HR 0.50, 95%
CI 0.28-0.91, P = .02) decreased the risk of all-cause mortality, while receipt of AC (HR 0.76, 95%
CI 0.41-1.41) was not significantly associated with an OS benefit, as compared to
no chemotherapy.
Conclusion
Our study is the first to evaluate treatment specific outcomes in male patients with
primary carcinoma of the urethra. We observed that neoadjuvant chemotherapy in men
with UUC was associated with OS benefit. The utilization of NAC may improve survival,
consistent with urothelial carcinoma of the bladder.
Keywords
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Article Info
Publication History
Published online: January 27, 2022
Accepted:
January 17,
2022
Received in revised form:
January 12,
2022
Received:
November 25,
2021
Footnotes
Submitted: Nov 25, 2021; Revised: Jan 12, 2022; Accepted: Jan 17, 2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
