Retrospective analysis of survival outcomes and the role of cisplatin-based chemotherapy in patients with urethral carcinomas referred to medical oncologists

Farshid Dayyani, Curtis A. Pettaway, Ashish M. Kamat, Mark F. Munsell, Kanishka Sircar, Lance C. Pagliaro

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Objectives: Primary carcinomas of the urethra (PCU) are rare and often advanced when diagnosed. Treatment standards are lacking. We studied treatment response and survival in a cohort of patients with PCU, with emphasis on modern platinum-containing chemotherapy regimens plus surgery for advanced disease. Materials and methods: This was a retrospective chart review of consecutive patients with PCU seen by medical oncologists at our institution over a recent 5-year period. Outcome was measured as best response to chemotherapy. Kaplan-Meier estimates were generated for survival and Cox proportional hazard was used for prognostic factors for survival. Results: The 44 patients (64% women) included had a median age at diagnosis of 66.5 years. The most prevalent histologic subtypes of PCU were squamous cell carcinoma and adenocarcinoma. At diagnosis, 43% already had lymph node-positive [lymph node (LN)+] disease, and 16% had distant metastases. The entire cohort's overall survival (OS) was 31.7 months. The response rate to platinum-containing neoadjuvant chemotherapy was 72%. Twenty-one patients with locally advanced or LN+ PCU underwent chemotherapy plus surgery. Their median OS from chemotherapy initiation was 25.6 months. Four of 9 patients (44%) with LN+ PCU at diagnosis were alive at our review, with a minimum follow-up of more than 3 years. Conclusions: Modern platinum-containing regimens appear to be effective in advanced PCU. Preoperative chemotherapy is associated with prolonged disease-free survival in a subgroup of LN+ cases.

Original languageEnglish (US)
Pages (from-to)1171-1177
Number of pages7
JournalUrologic Oncology: Seminars and Original Investigations
Volume31
Issue number7
DOIs
StatePublished - Oct 2013

Keywords

  • Cisplatin chemotherapy
  • Survival outcomes
  • Urethral carcinoma

ASJC Scopus subject areas

  • Oncology
  • Urology

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