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

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Abstract

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.

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Conflict of interest

None.

Ethical standard

This is an IRB-approved study conducted according to the Declaration of Helsinki.

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Authors and Affiliations

  1. Department of Urology, University of Tübingen, Tübingen, Germany

    Georgios Gakis, Johannes Mischinger, Tilman Todenhoefer, Tina Schubert & Arnulf Stenzl

  2. Department of Urology, University of Michigan, Ann Arbor, MI, USA

    Todd M. Morgan & Kola Olugbade Jr.

  3. Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Jason A. Efstathiou, Rebecca H. Clayman & Sigolene Galland

  4. Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA

    Kirk A. Keegan, Harras B. Zaid & Sam S. Chang

  5. Department of Urology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic

    Jan Hrbacek & Marko Babjuk

  6. Mansoura Clinic, Urology and Nephrology Center, Mansoura, Egypt

    Bedeir Ali-El-Dein

  7. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Michael Rink

  8. Department of Urology, University Hospital Regensburg, Regensburg, Germany

    Hans-Martin Fritsche & Maximilian Burger

  9. Department of Urology, University Hospital Berne, Berne, Switzerland

    George N. Thalmann

  10. USC/Norris Comprehensive Cancer Center, Institute of Urology, Los Angeles, CA, USA

    Siamak Daneshmand

Authors
  1. Georgios Gakis
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  2. Todd M. Morgan
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  3. Jason A. Efstathiou
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  4. Kirk A. Keegan
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  5. Johannes Mischinger
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  6. Tilman Todenhoefer
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  7. Tina Schubert
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  8. Harras B. Zaid
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  9. Jan Hrbacek
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  10. Bedeir Ali-El-Dein
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  11. Rebecca H. Clayman
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  12. Sigolene Galland
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  13. Kola Olugbade Jr.
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  14. Michael Rink
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  15. Hans-Martin Fritsche
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  16. Maximilian Burger
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  17. Sam S. Chang
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  18. Marko Babjuk
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  19. George N. Thalmann
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  20. Arnulf Stenzl
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  21. Siamak Daneshmand
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Corresponding author

Correspondence to Georgios Gakis.

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Gakis, G., Morgan, T.M., Efstathiou, J.A. et al. Prognostic factors and outcomes in primary urethral cancer: results from the international collaboration on primary urethral carcinoma. World J Urol 34, 97–103 (2016). https://doi.org/10.1007/s00345-015-1583-7

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  • DOI: https://doi.org/10.1007/s00345-015-1583-7

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