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World Journal of Urology

, Volume 34, Issue 1, pp 97–103 | Cite as

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

  • Georgios GakisEmail author
  • Todd M. Morgan
  • Jason A. Efstathiou
  • Kirk A. Keegan
  • Johannes Mischinger
  • Tilman Todenhoefer
  • Tina Schubert
  • Harras B. Zaid
  • Jan Hrbacek
  • Bedeir Ali-El-Dein
  • Rebecca H. Clayman
  • Sigolene Galland
  • Kola OlugbadeJr.
  • Michael Rink
  • Hans-Martin Fritsche
  • Maximilian Burger
  • Sam S. Chang
  • Marko Babjuk
  • George N. Thalmann
  • Arnulf Stenzl
  • Siamak Daneshmand
Original Article

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.

Keywords

Clinical Nodal stage Primary urethral carcinoma Prognostic Risk factors Survival 

Notes

Conflict of interest

None.

Ethical standard

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

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Georgios Gakis
    • 1
    Email author
  • Todd M. Morgan
    • 2
  • Jason A. Efstathiou
    • 3
  • Kirk A. Keegan
    • 4
  • Johannes Mischinger
    • 1
  • Tilman Todenhoefer
    • 1
  • Tina Schubert
    • 1
  • Harras B. Zaid
    • 4
  • Jan Hrbacek
    • 5
  • Bedeir Ali-El-Dein
    • 6
  • Rebecca H. Clayman
    • 3
  • Sigolene Galland
    • 3
  • Kola OlugbadeJr.
    • 2
  • Michael Rink
    • 7
  • Hans-Martin Fritsche
    • 8
  • Maximilian Burger
    • 8
  • Sam S. Chang
    • 4
  • Marko Babjuk
    • 5
  • George N. Thalmann
    • 9
  • Arnulf Stenzl
    • 1
  • Siamak Daneshmand
    • 10
  1. 1.Department of UrologyUniversity of TübingenTübingenGermany
  2. 2.Department of UrologyUniversity of MichiganAnn ArborUSA
  3. 3.Massachusetts General HospitalHarvard Medical SchoolBostonUSA
  4. 4.Department of Urologic SurgeryVanderbilt University Medical CenterNashvilleUSA
  5. 5.Department of Urology, 2nd Faculty of MedicineCharles UniversityPragueCzech Republic
  6. 6.Mansoura Clinic, Urology and Nephrology CenterMansouraEgypt
  7. 7.Department of UrologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  8. 8.Department of UrologyUniversity Hospital RegensburgRegensburgGermany
  9. 9.Department of UrologyUniversity Hospital BerneBerneSwitzerland
  10. 10.USC/Norris Comprehensive Cancer CenterInstitute of UrologyLos AngelesUSA

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