J Korean Med Sci.  2015 Aug;30(8):1143-1149. 10.3346/jkms.2015.30.8.1143.

Survival Outcomes and Predictive Factors for Female Urethral Cancer: Long-term Experience with Korean Patients

• Kang M
• Jeong CW
• Kwak C
• Kim HH
• Ku JH

• KMID: 2164510
• DOI: http://doi.org/10.3346/jkms.2015.30.8.1143

Abstract

The aim of this study was to evaluate female urethral cancer (UCa) patients treated and followed-up during a time period spanning more than 20 yr at single institution in Korea. We reviewed medical records of 21 consecutive patients diagnosed with female UCa at our institution between 1991 and 2012. After exclusion of two patients due to undefined histology, we examined clinicopathological variables, as well as survival outcomes of 19 patients with female UCa. A Cox proportional hazards ratio model was used to identify significant predictors of prognosis according to variables. The median age at diagnosis was 59 yr, and the median follow-up duration was 87.0 months. The most common initial symptoms were voiding symptoms and blood spotting. The median tumor size was 3.4 cm, and 55% of patients had lesions involving the entire urethra. The most common histologic type was adenocarcinoma, and the second most common type was urothelial carcinoma. Fourteen patients underwent surgery, and 7 of these patients received adjuvant radiation or systemic chemotherapy. Eleven patients experienced tumor recurrence after primary therapy. Patients with high stage disease, advanced T stage (> or =T3), and positive lymph nodes had worse survival outcomes compared to their counterparts. Particularly, lymph node positivity and advanced T stage were significant predictive factors for all survival outcomes. Tumor location was the only significant predictor for recurrence-free survival. Although our study included a small number of patients, it conveys valuable information about this rare female urologic malignancy in a Korean population.

Keyword

Female; Urethral Neoplasms; Survival; Outcome Assessment

MeSH Terms

Aged
Female
Humans
Longitudinal Studies
Middle Aged
Neoplasm Recurrence, Local/*mortality/*prevention & control
Prevalence
Prognosis
Republic of Korea/epidemiology
Risk Factors
Survival Rate
Treatment Outcome
Urethral Neoplasms/diagnosis/*mortality/*therapy
Women's Health/*statistics & numerical data

Figure

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  Fig. 1 Flow-chart of the treatment courses of the 19 patients with female urethral cancer in this study. The number of patients who were treated with specific modalities is described for each respective step. RT, radiation therapy; Tx, therapy; CTx, chemotherapy.

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  Fig. 2 Comparison of survival outcomes. (A) Recurrence-free survival, (B) cancer-specific survival, and (C) overall survival of female urethral cancer patients according to the American Joint Committee on Cancer staging guidelines analyzed by the Kaplan-Meier method and log-rank tests.

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  Fig. 3 Comparison of survival outcomes. (A) Recurrence-free survival, (B) cancer-specific survival, and (C) overall survival of female urethral cancer patients according to T stage analyzed by the Kaplan-Meier method and log-rank tests.

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  Fig. 4 Comparison of survival outcomes. (A) Recurrence-free survival, (B) cancer-specific survival, and (C) overall survival in female urethral cancer patients according to lymph node status analyzed by the Kaplan-Meier method and log-rank tests.

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