Prognostic factors and outcomes in primary urethral cancer: results from the international collaboration on primary urethral carcinoma

TY - JOUR

T1 - Prognostic factors and outcomes in primary urethral cancer: results from the international collaboration on primary urethral carcinoma

AU - Gakis, Georgios

AU - Morgan, Todd M

AU - Efstathiou, Jason A

AU - Keegan, Kirk A

AU - Mischinger, Johannes

AU - Todenhoefer, Tilman

AU - Schubert, Tina

AU - Zaid, Harras B

AU - Hrbacek, Jan

AU - Ali-El-Dein, Bedeir

AU - Clayman, Rebecca H

AU - Galland, Sigolene

AU - Olugbade, Kola

AU - Rink, Michael

AU - Fritsche, Hans-Martin

AU - Burger, Maximilian

AU - Chang, Sam S

AU - Babjuk, Marko

AU - Thalmann, George N

AU - Stenzl, Arnulf

AU - Daneshmand, Siamak

PY - 2016/1

Y1 - 2016/1

N2 - 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.

AB - 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.

U2 - 10.1007/s00345-015-1583-7

DO - 10.1007/s00345-015-1583-7

M3 - SCORING: Journal article

C2 - 25981402

VL - 34

SP - 97

EP - 103

JO - WORLD J UROL

JF - WORLD J UROL

SN - 0724-4983

IS - 1

ER -