- 作者：Farshid Dayyani ; Curtis A. Pettaway ; Ashish M. Kamat ; Mark F. Munsell ; Kanishka Sircar ; Lance C. Pagliaro
- 关键词：Urethral carcinoma ; Cisplatin chemotherapy ; Survival outcomes
- 刊名：Urologic Oncology: Seminars and Original Investigations
- 出版年：2013
- 出版时间：October, 2013
- 年：2013
- 卷：31
- 期：7
- 页码：1171-1177
- 全文大小：650 K
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.