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A brief review on the diagnostic and therapeutic principles of primary urethral cancer |
Hengchuan Sua,b,Yao Zhua,b,*( ),Dingwei Yea,b,*( )
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aDepartment of Urology, Fudan University Shanghai Cancer Center, Shanghai, China bDepartment of Oncology, Shanghai Medical College, FudanUniversity, Shanghai, China |
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Abstract Objective: Primary urethral carcinoma (PUC) is a rare malignant carcinoma but with limited therapeutic options. This review aims to provide an overview of the current strategies on this patient settings. Methods: Recent literature ranging from January 1987 and December 2021 was assessed through PubMed search to assess the diagnostic and therapeutic principles of PUC. Results: A complete of examination including cystoscopy, imaging, and biopsy should be conducted for these patients. Once diagnosed, the clinical decision of PUC should be made according to the tumor location, pathological pattern, and extent of the tumor. For patients with superficial and distal urethral lesions, organ sparing approaches or radical reconstructive procedures can be utilized. While for more advanced disease or nodal involvement, an optimal multimodal treatment strategy consisted of surgery and radiochemotherapy should be adopted. For patients with urothelial carcinoma of the prostate, the management including transurethral resection of the prostate followed by bacille Calmette-Guerin or radical cystoprostatectomy should depend on the infiltration depth of PUC. Conclusion: A complete of examination is important for the diagnosis of PUC. The management of PUC should be determined by the location, pathological pattern, and extent of the tumor. More multi-institutional collaborations should be held to investigate better treatment modalities for PUC.
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Received: 05 December 2021
Available online: 20 October 2022
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Corresponding Authors:
Yao Zhu,Dingwei Ye
E-mail: mailzhuyao@163.com;dwyeli@163.com
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[1] |
Visser O, Adolfsson J, Rossi S, Verne J, Gatta G, Maffezzini M, et al.; the RARECARE working group. Incidence and survival of rare urogenital cancers in Europe. Eur J Cancer 2012; 48: 456e64.
|
[2] |
Aron M, Park S, Lowenthal BM, Gupta S, Sahoo D, Cheville JC, et al. Primary female urethral carcinoma: proposed staging modifications based on assessment of female urethral histology and analysis of a large series of female urethral carcinomas. Am J Surg Pathol 2020; 44:1591e601.
|
[3] |
Wenzel M, Nocera L, Collà Ruvolo C, Würnschimmel C, Tian Z, Shariat SF, et al. Incidence rates and contemporary trends in primary urethral cancer. Cancer Causes Control 2021; 32: 627e34.
|
[4] |
Ayun Cassell 3rd, Manobah Burgess, Willie Soeghen. Diagnostic and therapeutic challenges of rare urogenital cancers: urothelial carcinoma of the renal pelvis, ureters and urethra. World J Oncol 2021; 12:20e7.
|
[5] |
Krukowski J, Czajkowski M, K?a?cz J, Wawrzaszek O, Go?e?biewska M, Matuszewski M. Primary urethral carcinomad unexpected cause of urethral stricture. Case report and review of the literature. Med Ultrason 2019; 21:494e6.
|
[6] |
Janisch F, Abufaraj M, Fajkovic H, Kimura S, Iwata T, Nyirady P, et al. Current disease management of primary urethral carcinoma. Eur Urol Focus 2019; 5:722e34.
|
[7] |
Zinman LN, Vanni AJ. Management of proximal primary urethral cancer: should multidisciplinary therapy be the gold standard. Urol Clin 2016; 43:505e13.
|
[8] |
Karnes RJ, Breau RH, Lightner DJ. Surgery for urethral cancer. Urol Clin 2010; 37:445e57.
|
[9] |
Barkan GA, Wojcik EM, Nayar R, Savic-Prince S, Quek ML, Kurtycz DF, et al. The Paris System for reporting urinary cytology: the quest to develop a standardized terminology. Acta Cytol 2016; 60:185e97.
|
[10] |
Wang N, Min J, Wei Q, Tan W, Dang Q. Primary urothelium carcinoma of the distal urethra in a male: case report and literature review. Onco Targets Ther 2020; 13:6011e5.
|
[11] |
Gakis G, Efstathiou JA, Daneshmand S, Keegan KA, Clayman RH, Hrbacek J, et al. Oncological outcomes of patients with concomitant bladder and urethral carcinoma. Urol Int 2016; 97:134e41.
|
[12] |
Nixon RG, Chang SS, Lafleur BJ, Smith JA, Cookson MS. Carcinoma in situ and tumor multifocality predict the risk of prostatic urethral involvement at radical cystectomy in men with transitional cell carcinoma of the bladder. J Urol 2002; 167:502e5.
|
[13] |
Antonov P, Raycheva G. A rare case of a patient with primary urothelial carcinoma of the prostate urethradmultidisciplinary approach. Urol Case Rep 2021; 38:101643. https://doi.org/10.1016/j.eucr.2021.101643.
|
[14] |
Donat SM, Wei DC, McGuire MS, Herr HW. The efficacy of transurethral biopsy for predicting the long-term clinical impact of prostatic invasive bladder cancer. J Urol 2001; 165: 1580e4.
|
[15] |
von Rundstedt FC, Lerner SP, Godoy G. Usefulness of transurethral biopsy for staging the prostatic urethra before radical cystectomy. J Urol 2015; 193:58e63.
|
[16] |
Walsh E, Kelly N, Daly P, Shah N, Cullen I. Urethral cancer managed with phallus preserving surgery: a case report. J Med Case Rep 2021; 15:91. https://doi.org/10.1186/s13256-020-02553-z.
|
[17] |
Van Der Molen AJ, Cowan NC, Mueller-Lisse UG, Nolte- Ernsting CC, Takahashi S, Cohan RH. CT urography: definition, indications and techniques. A guideline for clinical practice. Eur Radiol 2008; 18:4e17.
|
[18] |
Gourtsoyianni S, Hudolin T, Sala E, Goldman D, Bochner BH, Hricak H. MRI at the completion of chemoradiotherapy can accurately evaluate the extent of disease in women with advanced urethral carcinoma undergoing anterior pelvic exenteration. Clin Radiol 2011; 66:1072e8.
|
[19] |
Gakis G, Morgan TM, Efstathiou JA, Keegan KA, Mischinger J, Todenhoefer T, et al. Prognostic factors and outcomes in primary urethral cancer: results from the international collaboration on primary urethral carcinoma. World J Urol 2016; 34:97e103.
|
[20] |
Rabbani F. Prognostic factors in male urethral cancer. Cancer 2011; 117:2426e34.
|
[21] |
Aleksic I, Rais-Bahrami S, Daugherty M, Agarwal PK, Vourganti S, Bratslavsky G. Primary urethral carcinoma: a Surveillance, Epidemiology, and End Results data analysis identifying predictors of cancer-specific survival. Urol Ann 2018; 10:170e4.
|
[22] |
Sui W, RoyChoudhury A, Wenske S, Decastro GJ, McKiernan JM, Anderson CB. Outcomes and prognostic factors of primary urethral cancer. Urology 2017; 100:180e6.
|
[23] |
Gatta M. Surveillance of rare cancers in Europe. http://www.eurocare.it.[Accessed 2 January 2019].
|
[24] |
Zi H, Gao L, Yu Z, Wang C, Ren X, Lyu J, et al. Nomograms for predicting long-term overall survival and cancer-specific survival in patients with primary urethral carcinoma: a population-based study. Int Urol Nephrol 2020; 52:287e300.
|
[25] |
Gakis G, Bruins HM, Cathomas R, Compérat EM, Cowan NC, van der Heijden AG, et al. EAU guidelines on primary urethral carcinoma, https://uroweb.org/guidelines/primary-urethralcarcinoma[Accessed 2 March 2021].
|
[26] |
Derksen JW, Visser O, Meuleman EJ, Heldeweg EA, Lagerveld BW. Primary urethral carcinoma in females: an epidemiologic study on demographical factors, histological types, tumour stage and survival. World J Urol 2013; 31:147e53.
|
[27] |
Meis JM, Ayala AG, Johnson DE. Adenocarcinoma of the urethra in women. A clinicopathologic study. Cancer 1987; 60: 1038e52.
|
[28] |
Wu J, Wang YC, Luo WJ, Bo-Dai, Ye DW, Zhu YP. Primary tumor surgery improves survival in non-metastatic primary urethral carcinoma patients: a large population-based investigation. BMC Cancer 2021; 21:857. https://doi.org/10.1186/s12885-021-08603-z.
doi: 10.1186/s12885-021-08603-z
pmid: 34315433
|
[29] |
Berjeaut RH, Persaud MD, Sopko N, Burnett AL. Urethral carcinoma in situ: recognition and management. Int Urol Nephrol 2017; 49:637e41.
|
[30] |
Calderón Cortez JF, Territo A, Fontana M, Gaya JM, Sanguedolce F, Palou J, et al. Primary urethral carcinoma: results from a single center experience. Actas Urol Esp 2021;S0210-4806:96e106. https://doi.org/10.1016/j.acuro.2020.10.014.
|
[31] |
Gakis G, Witjes JA, Comperat E, Cowan NC, DeSantis M, Lebret T, et al. EAU guidelines on primary urethral carcinoma. Eur Urol 2013; 64:823e30.
|
[32] |
Kitamura Y, Horiguchi A, Ojima K, Kawamura K, Shinchi M, Asano T, et al. Penile-preserving surgery for male distal urethral carcinoma followed by buccal mucosa urethroplasty. IJU Case Rep 2019; 27:198e201.
|
[33] |
Smith Y, Hadway P, Ahmed S, Perry MJ, Corbishley CM, Watkin NA. Penile-preserving surgery for male distal urethral carcinoma. BJU Int 2007; 100:82e7.
|
[34] |
Torbrand C, Hakansson U, Ehrnstrom R, Liedberg F. Diagnosing distal urethral carcinomas in men might be only the tip of the iceberg. Clin Genitourin Cancer 2017; 15:e1131e5. https://doi.org/10.1016/j.clgc.2017.07.006.
|
[35] |
Traboulsi SL, Witjes JA, Kassouf W. Contemporary management of primary distal urethral cancer. Urol Clin 2016; 43: 493e503.
|
[36] |
Flaig TW, Spiess PE, Agarwal N, Bangs R, Boorjian SA, Buyyounouski MK, et al. Bladder cancer, version 3.2020, NCCN clinical practice guidelines in oncology. J Natl Compr Cancer Netw 2020; 18:329e54.
|
[37] |
Castiglione F, Alnajjar HM, Christodoulidou M, Albersen M, Parnham A, Freeman A, et al. Primary squamous cell carcinoma of the male proximal urethra: outcomes from a single centre. Eur Urol Focus 2021; 7:163e9.
|
[38] |
Dimarco DS, Dimarco CS, Zincke H, Webb MJ, Bass SE, Slezak JM, et al. Surgical treatment for local control of female urethral carcinoma. Urol Oncol 2004; 22:404e9.
|
[39] |
Dalbagni G, Zhang ZF, Lacombe L, Herr HW. Female urethral carcinoma: an analysis of treatment outcome and a plea for a standardized management strategy. Br J Urol 1998; 82: 835e41.
|
[40] |
Anderson CB, McKiernan JM. Tumors of the urethra. In: Partin A, Peters C, Kavoussi L, editors. Campbell-Walsh Urology. 12th ed. Philadelphia: Elsevier; 2020. p. 1776e89.
|
[41] |
Milosevic MF, Warde PR, Banerjee D, Gospodarowicz MK, McLean M, Catton PA, et al. Urethral carcinoma in women: results of treatment with primary radiotherapy. Radiother Oncol 2000; 56:29e35.
|
[42] |
Son CH, Liauw SL, Hasan Y, Solanki AA. Optimizing the role of surgery and radiation therapy in urethral cancer based on histology and disease extent. Int J Radiat Oncol Biol Phys 2018; 102:304e13.
|
[43] |
Flaig TW, Spiess PE, Aber M, Agarwal N, Bangs R, Boorjian S, et al. NCCN clinical practice guidelines in oncology-bladder cancer (version 1.2022). https://www.nccn.org/guidelines/guidelines-detail?categoryZ1&idZ1417.[Accessed 20 May 2022].
|
[44] |
Babjuk M, Bohle A, Burger M, Capoun O, Cohen D, Comperat EM, et al. EAU Guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2016. Eur Urol 2017; 71:447e61.
|
[45] |
Dayyani F, Pettaway CA, Kamat AM, Munsell MF, Sircar K, Pagliaro LC. Retrospective analysis of survival outcomes and the role of cisplatin-based chemotherapy in patients with urethral carcinomas referred to medical oncologists. Urol Oncol 2013; 31:1171e7.
|
[46] |
Gakis G, Morgan TM, Daneshmand S, Keegan KA, Todenh?fer T, Mischinger J, et al. Impact of perioperative chemotherapy on survival in patients with advanced primary urethral cancer: results of the international collaboration on primary urethral carcinoma. Ann Oncol 2015; 26:1754e9.
|
[47] |
Mano R, Vertosick EA, Sarcona J, Sjoberg DD, Benfante NE, Donahue TF. Primary urethral cancer: treatment patterns and associated outcomes. BJU Int 2020; 126:359e66.
|
[48] |
Peyton CC, Azizi M, Chipollini J, Ercole C, Fishman M, Gilbert SM, et al. Survival outcomes associated with female primary urethral carcinoma: review of a single institutional experience. Clin Genitourin Cancer 2018; 16:e1003e13. https://doi.org/10.1016/j.clgc.2018.05.012.
|
[49] |
Kent M, Zinman L, Girshovich L, Sands J, Vanni A. Combined chemoradiation as primary treatment for invasive male urethral cancer. J Urol 2015; 193:532e7.
|
[50] |
Mano R, Vertosick EA, Sarcona J, Sjoberg DD, Benfante NE, Donahue TF, et al. Primary urethral cancerdtreatment patterns and associated outcomes. BJU Int 2020; 126:359e66.
|
[51] |
Eng TY, Chen TW, Patel AJ, Vincent JN, Ha CS. Treatment and outcomes of primary urethra cancer. Am J Clin Oncol 2018; 41: 905e8.
|
[52] |
Cohen MS, Triaca V, Billmeyer B, Hanley RS, Girshovich L, Shuster T, et al. Coordinated chemoradiation therapy with genital preservation for the treatment of primary invasive carcinoma of the male urethra. J Urol 2008; 179:536e41.
|
[53] |
Gakis G, Schubert T, Morgan TM, Daneshmand S, Keegan KA, Mischinger J, et al. The prognostic effect of salvage surgery and radiotherapy in patients with recurrent primary urethral carcinoma. Urol Oncol 2018; 36:10.e7e14. https://doi.org/10.1016/j.urolonc.2017.09.012.
|
[54] |
Werntz RP, Riedinger CB, Fantus RJ, Smith ZL, Packiam VT, Adamsky MA, et al. The role of inguinal lymph node dissection in men with urethral squamous cell carcinoma. Urol Oncol 2018; 36:52.e1e6. https://doi.org/10.1016/j.urolonc.2018.09.014.
|
[55] |
Rose KM, Abdul-Muhsin H, Wilson J, Dybal EJ, Janosek K. Primary urethral carcinoma with nodal metastasis. Fed Pract 2019; 36(Suppl 1):S27e9. PMID: 30867633.
|
[56] |
Kokorovic A, Westerman ME, Krause K, Hernandez M, Brooks N, Dinney CPN, et al. Revisiting an old conundrum: a systematic review and meta-analysis of intravesical therapy for treatment of urothelial carcinoma of the prostate. Bladder Cancer 2021; 7:243e52.
|
[57] |
Gofrit ON, Pode D, Pizov G, Zorn KC, Katz R, Shapiro A. Prostatic urothelial carcinoma: is transurethral prostatectomy necessary before bacillus Calmette-Guérin immunotherapy? BJU Int 2009; 103:905e8.
|
[58] |
Palou Redorta J, Schatteman P, Huguet Pérez J, Segarra Tomás J, Rosales Bordes A, Algaba F, et al. Intravesical instillations with bacillus calmette-guérin for the treatment of carcinoma in situ involving prostatic ducts. Eur Urol 2006; 49:834e8.
|
[59] |
Shen SS, Lerner SP, Muezzinoglu B, Truong LD, Amiel G, Wheeler TM. Prostatic involvement by transitional cell carcinoma in patients with bladder cancer and its prognostic significance. Hum Pathol 2006; 37:726e34.
|
[60] |
Stein JP, Clark P, Miranda G, Cai J, Groshen S, Skinner DG. Urethral tumor recurrence following cystectomy and urinary diversion: clinical and pathological characteristics in 768 male patients. J Urol 2005; 173:1163e8.
|
[61] |
Wenzel M, Deuker M, Nocera L, Ruvolo CC, Tian Z, Shariat SF, et al. Comparison between urothelial and non-urothelial urethral cancer. Front Oncol 2021; 10:629692. https://doi.org/10.3389/fonc.2020.629692.
|
[62] |
Balar AV, Castellano D, O’Donnell PH, Grivas P, Vuky J, Powles T, et al. First-line pembrolizumab in cisplatinineligible patients with locally advanced and unresectable or metastatic urothelial cancer (KEYNOTE-052): a multicentre, single-arm, phase 2 study. Lancet Oncol 2017; 18: 1483e92.
|
[63] |
Pedrosa JA, Amstutz SP, Bihrle R, Mellon MJ. Distal urethrectomy for localized penile squamous carcinoma in situ extending into the urethra: an updated series. Int Urol Nephrol 2014; 46:1551e5.
|
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