Dayyani F, Hoffman K, Eifel P, Guo C, Vikram R, Pagliaro LC, et al. Management of advanced primary urethral carcinomas. BJU Int. 2014 Jul. 114 (1):25-31. [QxMD MEDLINE Link]. [Full Text].
PDQ Adult Treatment Editorial Board. Urethral Cancer Treatment (PDQ®): Health Professional Version. January 31, 2020. [QxMD MEDLINE Link]. [Full Text].
Gatta G, van der Zwan JM, Casali PG, Siesling S, Dei Tos AP, Kunkler I, et al. Rare cancers are not so rare: The rare cancer burden in Europe. Eur J Cancer. 2011 Nov. 47(17):2493-511. [QxMD MEDLINE Link].
Visser O, Adolfsson J, Rossi S, Verne J, Gatta G, Maffezzini M, et al. Incidence and survival of rare urogenital cancers in Europe. Eur J Cancer. 2012 Mar. 48(4):456-64. [QxMD MEDLINE Link].
Aleksic I, Rais-Bahrami S, Daugherty M, Agarwal PK, Vourganti S, Bratslavsky G. Primary urethral carcinoma: A Surveillance, Epidemiology, and End Results data analysis identifying predictors of cancer-specific survival. Urol Ann. 2018 Apr-Jun. 10 (2):170-174. [QxMD MEDLINE Link]. [Full Text].
Hakenberg OW, Compérat EM, Minhas S, Necchi A, Protzel C, Watkin N, et al. EAU guidelines on penile cancer: 2014 update. Eur Urol. 2015 Jan. 67 (1):142-50. [QxMD MEDLINE Link].
Deberne M, Timsit MO, Verkarre V, Eiss D, Kreps S, Dupont S, et al. Multimodal management of primary adenocarcinoma of the female urethra: About four cases. Cancer Radiother. 2016 May. 20 (3):169-75. [QxMD MEDLINE Link].
Tsai YS, Yang WH, Tong YC, Lin JS, Pan CC, Tzai TS. Experience with primary urethral carcinoma from the blackfoot disease-endemic area of South Taiwan: increased frequency of bulbomembranous adenocarcinoma?. Urol Int. 2005. 74(3):229-34. [QxMD MEDLINE Link].
Swartz MA, Porter MP, Lin DW, Weiss NS. Incidence of primary urethral carcinoma in the United States. Urology. 2006 Dec. 68(6):1164-8. [QxMD MEDLINE Link].
[Guideline] Gakis G, Bruins HM, Cathomas R, Compérat EM, Cowan NC, van der Heijden AG, et al. European Association of Urology Guidelines on Primary Urethral Carcinoma-2020 Update. Eur Urol Oncol. 2020 Aug. 3 (4):424-432. [QxMD MEDLINE Link]. [Full Text].
Mano R, Vertosick EA, Sarcona J, Sjoberg DD, Benfante NE, Donahue TF, et al. Primary urethral cancer: treatment patterns and associated outcomes. BJU Int. 2020 Apr 26. [QxMD MEDLINE Link].
Lucarelli G, Spilotros M, Vavallo A, Palazzo S, Miacola C, Forte S, et al. A Challenging Surgical Approach to Locally Advanced Primary Urethral Carcinoma: A Case Report and Literature Review. Medicine (Baltimore). 2016 May. 95 (19):e3642. [QxMD MEDLINE Link]. [Full Text].
Rabbani F. Prognostic factors in male urethral cancer. Cancer. 2011 Jun 1. 117 (11):2426-34. [QxMD MEDLINE Link]. [Full Text].
Grivas PD, Davenport M, Montie JE, Kunju LP, Feng F, Weizer AZ. Urethral cancer. Hematol Oncol Clin North Am. 2012 Dec. 26(6):1291-314. [QxMD MEDLINE Link]. [Full Text].
Dalbagni G, Zhang ZF, Lacombe L, Herr HW. Male urethral carcinoma: analysis of treatment outcome. Urology. 1999 Jun. 53(6):1126-32. [QxMD MEDLINE Link].
Gourtsoyianni S, Hudolin T, Sala E, Goldman D, Bochner BH, Hricak H. MRI at the completion of chemoradiotherapy can accurately evaluate the extent of disease in women with advanced urethral carcinoma undergoing anterior pelvic exenteration. Clin Radiol. 2011 Nov. 66(11):1072-8. [QxMD MEDLINE Link].
Amin, M.B., Edge, S., Greene, F., et al. AJCC Cancer Staging Manual. 8th Edition. New York: Springer; 2017. 1032.
Janisch F, Abufaraj M, Fajkovic H, Kimura S, Iwata T, Nyirady P, et al. Current Disease Management of Primary Urethral Carcinoma. Eur Urol Focus. 2019 Sep. 5(5):722-734. [QxMD MEDLINE Link].
Stone BV, Hill SC, Moses KA. The effect of centralization of care on overall survival in primary urethral cancer. Urol Oncol. 2021 Feb. 39(2):133.e17-133.e26. [QxMD MEDLINE Link].
Serrano N, Chang M, Leland Rogers C, Orton M, Mannino R, Grob M, et al. Patient autonomy and shared decision making in the management of urethral cancer. Pract Radiat Oncol. 2015 Sep 12. [QxMD MEDLINE Link].
Garden AS, Zagars GK, Delclos L. rimary carcinoma of the female urethra. Results of radiation therapy. Cancer. 1993 May. 71(10):3102-8. [QxMD MEDLINE Link].
[Guideline] National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Bladder Cancer. NCCN. Available at https://www.nccn.org/professionals/physician_gls/pdf/bladder.pdf. Version 4.2021 — July 16, 2021;
Griffiths G, Hall R, Sylvester R, Raghavan D, Parmar MK. International phase III trial assessing neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscle-invasive bladder cancer: long-term results of the BA06 30894 trial. J Clin Oncol. 2011 Jun 1. 29(16):2171-7. [QxMD MEDLINE Link]. [Full Text].
Zhang M, Adeniran AJ, Vikram R, Tamboli P, Pettaway C, Bondaruk J, et al. Carcinoma of the urethra. Hum Pathol. 72. 2018 Feb:35-44. [QxMD MEDLINE Link].
Dayyani F, Pettaway CA, Kamat AM, Munsell MF, Sircar K, Pagliaro LC. Retrospective analysis of survival outcomes and the role of cisplatin-based chemotherapy in patients with urethral carcinomas referred to medical oncologists. Urol Oncol. 2013 Oct. 31(7):1171-7. [QxMD MEDLINE Link].
Dinney CP, Johnson DE, Swanson DA, et al. Therapy and prognosis for male anterior urethral carcinoma: an update. Urology. 1994 Apr. 43(4):506-14. [QxMD MEDLINE Link].
Eng TY, Naguib M, Galang T, Fuller CD. Retrospective study of the treatment of urethral cancer. Am J Clin Oncol. 2003 Dec. 26(6):558-62. [QxMD MEDLINE Link].
Cohen MS, Triaca V, Billmeyer B, Hanley RS, Girshovich L, Shuster T, et al. Coordinated chemoradiation therapy with genital preservation for the treatment of primary invasive carcinoma of the male urethra. J Urol. 2008 Feb. 179(2):536-41. [QxMD MEDLINE Link].
Oliva E, Quinn TR, Amin MB, et al. Primary malignant melanoma of the urethra: a clinicopathologic analysis of 15 cases. Am J Surg Pathol. 2000 Jun. 24(6):785-96. [QxMD MEDLINE Link].
Wu J, Wang YC, Luo WJ, Bo-Dai, Ye DW, Zhu YP. Primary tumor surgery improves survival in non-metastatic primary urethral carcinoma patients: a large population-based investigation. BMC Cancer. 2021 Jul 27. 21(1):857. [QxMD MEDLINE Link].
Madeb R, Golijanin DJ, Messing E, et al. Urethral Cancer in Women. Basow, DS. UpToDate. Waltham, MA: UpToDate; 2013.
Kaplan GW, Bulkey GJ, Grayhack JT. Carcinoma of the male urethra. J Urol. 1967 Sep. 98(3):365-71. [QxMD MEDLINE Link].
Karnes RJ, Breau RH, Lightner DJ. Surgery for urethral cancer. Urol Clin North Am. 2010 Aug. 37(3):445-57. [QxMD MEDLINE Link].
Dimarco DS, Dimarco CS, Zincke H, Webb MJ, Bass SE, Slezak JM, et al. Surgical treatment for local control of female urethral carcinoma. Urol Oncol. 2004 Sep-Oct. 22(5):404-9. [QxMD MEDLINE Link].
DiMarco DS, DiMarco CS, Zincke H, Webb MJ, Keeney GL, Bass S, et al. Outcome of surgical treatment for primary malignant melanoma of the female urethra. J Urol. 2004 Feb. 171(2 Pt 1):765-7. [QxMD MEDLINE Link].
Chan Y, Fisher P, Tilki D, Evans CP. Urethral Recurrence After Cystectomy: Current Preventative Measures, Diagnosis and Management. BJU Int. 2015 Nov 11. [QxMD MEDLINE Link].
Gakis G, Morgan TM, Daneshmand S, Keegan KA, Todenhöfer T, Mischinger J, et al. Impact of perioperative chemotherapy on survival in patients with advanced primary urethral cancer: results of the international collaboration on primary urethral carcinoma. Ann Oncol. 2015 Aug. 26(8):1754-9. [QxMD MEDLINE Link]. [Full Text].
Gakis G, Schubert T, Morgan TM, Daneshmand S, Keegan KA, Mischinger J, et al. The prognostic effect of salvage surgery and radiotherapy in patients with recurrent primary urethral carcinoma. Urol Oncol. 2018 Jan. 36 (1):10.e7-10.e14. [QxMD MEDLINE Link].
Wenzel M, Deuker M, Nocera L, Collà Ruvolo C, Tian Z, Shariat SF, et al. Comparison Between Urothelial and Non-Urothelial Urethral Cancer. Front Oncol. 2021 Jan 29. 10:629692. [QxMD MEDLINE Link]. [Full Text].
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020 Jan. 70 (1):7-30. [QxMD MEDLINE Link]. [Full Text].

Media Gallery

Male urethral anatomy from most proximal to distal. Shown is the prostatic urethra (from bladder neck to the urogenital diaphragm [UGD]), membranous urethra (traversing the UGD), bulbous urethra (from the UGD to the penoscrotal junction), and the penile or pendulous urethra (from the penoscrotal junction traversing distally) with its boat-shaped most distal aspect, the fossa navicularis. Note the adjacent structures of the corpus cavernosum, bladder, prostate, pubic symphysis, perineum, and scrotum, which are sites of local extension and often are excised en bloc.
(A) Normal anatomy. Sagittal T2-weighted image labelling the prostatic, membranous, and bulbous segments of the normal male urethra. (B) Normal anatomy. Illustration of the normal female urethra in axial cross-section. (C) Normal anatomy. Axial T2-weighted image of a normal female urethra. Note the hypointense signal of the mucosa and outer muscular layer and hyperintense submucosa. Image used with permission from Del Gaizo A et al, Magnetic resonance imaging of solid urethral and peri-urethral lesions. Insights Imaging. Aug 2013;4(4):461-9. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3731464/.
Illustration of the male urethra in the sagittal plane highlighting the percentage of urethral carcinoma by location (1st percentage) and the most common histological subtype in that location (2nd percentage). TCC = transitional cell carcinoma, SCC = squamous cell carcinoma. Image used with permission from Del Gaizo A et al, Magnetic resonance imaging of solid urethral and peri-urethral lesions. Insights Imaging. Aug 2013;4(4):461-9. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3731464/.

of 3

Table 1. TNM Classification for Urethral Cancer

Primary tumor (T)
Male penile urethra and female urethra
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Ta	Noninvasive papillary carcinoma
Tis	Carcinoma in situ
T1	Tumor invades subepithelial connective tissue
T2	Tumor invades the corpus spongiosum or periurethral muscle
T3	Tumor invades the corpus cavernosum or anterior vagina
T4	Tumor invades other adjacent organs (eg, bladder wall)
Prostatic urethra
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Ta	Noninvasive papillary carcinoma
Tis	Carcinoma in situ involving the prostatic urethra or periurethral or prostatic ducts without stromal invasion
T1	Tumor invades urethral subepithelial connective tissue immediately underlying the urothelium
T2	Tumor invades the prostatic stroma surrounding ducts either by direct extension from the urothelial surface or by invasion from prostatic ducts
T3	Tumor invades the periprostatic fat
T4	Tumor invades other adjacent organs (ie, extraprostatic invasion of the bladder wall, rectal wall)
Regional lymph nodes (N)
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Single regional lymph node metastasis in the inguinal region or true pelvis or presacral lymph node
N2	Multiple lymph node metastases in the inguinal region or true pelvis or presacral lymph node
Distant metastasis (M)
MX	Distant metastasis cannot be assessed
MO	No distant metastasis
M1	Distant metastasis

Table 2. AJCC Prognostic Groups

Stage	T	N	M
Stage 0a	Ta	N0	M0
Stage 0is	Tis	N0	M0
Stage I	T1	N0	M0
Stage II	T2	N0	M0
Stage III	T1	N1	M0
	T2	N1	M0
	T3	N0	M0
	T3	N1	M0
Stage IV	T4	N1	M0
	Any T	N2	M0
	Any T	Any N	M1

Back to List

Author

Shahrokh F Shariat, MD Professor and Chairman, Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital; Adjunct Professor of Urology and Medical Oncology, Weill Cornell Medical College; Adjunct Professor of Urology, University of Texas Southwestern Medical School; Honorary Professor of Urology, Second Faculty of Medicine, Charles University, Czech Republic; Honorary Professor of Urology, University of Jordan Faculty of Medicine, Jordan

Shahrokh F Shariat, MD is a member of the following medical societies: American Association for Cancer Research, American Association of Clinical Urologists, American College of Surgeons, American Society for Men's Health, American Society of Clinical Oncology, American Urological Association, Association of Academic European Urologists, Association of US Trained European Physicians, Austrian Society for Urology and Andrology, Bladder Cancer Advocacy Network, Bladder Cancer Early Detection Network, Bladder Cancer Research Consortium, Central European Urological Society, EAU Section of Genitourinary Reconstructive Surgeons, European Association of Urology, Endourological Society, European Academy of Sciences and Arts, European Association of Urology, Foundation for Men's Health, German Society of Urology, Iranian American Urological Society, International Bladder Cancer Network, IVALKV, Men's Health Network, Minimally Invasive Robotic Association, New York Academy of Sciences, New York Section of the American Urological Association, Society for Basic Urologic Research, Society of University Urologists, Society of Urologic Oncology, Texas Medical Association, Upper Tract Urothelial Carcinoma Collaboration

Disclosure: Nothing to disclose.

Coauthor(s)

Ekaterina Laukhtina, MD Research Fellow, Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Austria; Researcher, Institute for Urology and Reproductive Health, IM Sechenov First Moscow State Medical University, Russia

Ekaterina Laukhtina, MD is a member of the following medical societies: American Urological Association, European Association of Urology

Disclosure: Nothing to disclose.

Benjamin Pradere, MD, MSc Faculty Member and Urologist, Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Austria

Benjamin Pradere, MD, MSc is a member of the following medical societies: Association Française des Urologues en Formation, Association Française d’Urologie, European Association of Urology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Bradley Fields Schwartz, DO, FACS Professor of Urology, Director, Center for Laparoscopy and Endourology, Department of Surgery, Southern Illinois University School of Medicine

Bradley Fields Schwartz, DO, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Association of Military Osteopathic Physicians and Surgeons, Endourological Society, Society of Laparoendoscopic Surgeons, Society of University Urologists

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Endourological Society Board of Directors; President Elect North Central Section of the American Urological Association<br/>Serve(d) as a speaker or a member of a speakers bureau for: Cook Medical.

Additional Contributors

Jack H Mydlo, MD Chief, Department of Urology, Woodhull Hospital; Chair and Professor, Department of Urology, Temple University School of Medicine

Jack H Mydlo, MD is a member of the following medical societies: American College of Surgeons, American Urological Association, International College of Surgeons US Section, Society of University Urologists

Disclosure: Nothing to disclose.

Jeffrey M Donohoe, MD, FAAP Assistant Professor of Pediatric Urology, Department of Surgery, Division of Urology, Children’s Medical Center, Medical College of Georgia

Jeffrey M Donohoe, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics, American Urological Association

Disclosure: Nothing to disclose.

Christopher Powell, MD Resident Physician, Department of Urology, University of Kansas Medical Center

Christopher Powell, MD is a member of the following medical societies: American Medical Association

Disclosure: Nothing to disclose.

Joseph Guidos University of Missouri-Kansas City School of Medicine

Joseph Guidos is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Surgeons, American Medical Association, American Medical Student Association/Foundation, American Urological Association, Missouri State Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

Dan Theodorescu, MD, PhD Paul A Bunn Professor of Cancer Research, Professor of Surgery and Pharmacology, Director, University of Colorado Comprehensive Cancer Center

Dan Theodorescu, MD, PhD is a member of the following medical societies: American Cancer Society, American College of Surgeons, American Urological Association, Medical Society of Virginia, Society for Basic Urologic Research, and Society of Urologic Oncology

Disclosure: Key Genomics Ownership interest Co-Founder-50% Stock Ownership; KromaTiD, Inc Stock Options Board membership

Urethral Cancer Questions & Answers

References

Tables

Contributor Information and Disclosures

What would you like to print?