TY - JOUR
T1 - Association Between Perioperative Chemotherapy and Survival in Men Undergoing Radical Resection for Primary Urethral Urothelial Carcinoma
T2 - An Analysis of the National Cancer Database
AU - Celtik, Kenan
AU - Lim, Kelvin
AU - Dursun, Furkan
AU - Xu, Jiaqiong
AU - Klaassen, Zachary
AU - Zhang, Jun
AU - Efstathiou, Eleni
AU - Sonpavde, Guru
AU - Wallis, Christopher
AU - Satkunasivam, Raj
N1 - Copyright © 2022. Published by Elsevier Inc.
PY - 2022/6
Y1 - 2022/6
N2 - Introduction: The treatment landscape in invasive primary carcinoma of the urethra of urothelial histology closely aligns that of locally advanced urothelial carcinoma of the bladder. The survival benefit of perioperative chemotherapy for men undergoing radical surgery for primary urethral urothelial carcinoma (UUC) has not yet been well-elucidated. Patients and Methods: Using the National Cancer Database (NCDB), we identified men diagnosed with non-metastatic invasive UUC (T2-4 N0-2 M0) from 2004 to 2016 treated with radical extirpative surgery. We compared OS between patients who had received peri-operative neoadjuvant (NAC) or adjuvant (AC) chemotherapy and those who had not using Kaplan-Meier curves and multivariable Cox proportional hazards regression model. Results: A total of 191 patients met inclusion criteria. 113 patients (59.2%) did not receive chemotherapy, while 39 (20.4%) and 39 (20.4%) received NAC and AC, respectively. Median follow-up was 28.0 months. Upon multivariable analysis, receipt of NAC (HR 0.50, 95% CI 0.28-0.91, P = .02) decreased the risk of all-cause mortality, while receipt of AC (HR 0.76, 95% CI 0.41-1.41) was not significantly associated with an OS benefit, as compared to no chemotherapy. Conclusion: Our study is the first to evaluate treatment specific outcomes in male patients with primary carcinoma of the urethra. We observed that neoadjuvant chemotherapy in men with UUC was associated with OS benefit. The utilization of NAC may improve survival, consistent with urothelial carcinoma of the bladder.
AB - Introduction: The treatment landscape in invasive primary carcinoma of the urethra of urothelial histology closely aligns that of locally advanced urothelial carcinoma of the bladder. The survival benefit of perioperative chemotherapy for men undergoing radical surgery for primary urethral urothelial carcinoma (UUC) has not yet been well-elucidated. Patients and Methods: Using the National Cancer Database (NCDB), we identified men diagnosed with non-metastatic invasive UUC (T2-4 N0-2 M0) from 2004 to 2016 treated with radical extirpative surgery. We compared OS between patients who had received peri-operative neoadjuvant (NAC) or adjuvant (AC) chemotherapy and those who had not using Kaplan-Meier curves and multivariable Cox proportional hazards regression model. Results: A total of 191 patients met inclusion criteria. 113 patients (59.2%) did not receive chemotherapy, while 39 (20.4%) and 39 (20.4%) received NAC and AC, respectively. Median follow-up was 28.0 months. Upon multivariable analysis, receipt of NAC (HR 0.50, 95% CI 0.28-0.91, P = .02) decreased the risk of all-cause mortality, while receipt of AC (HR 0.76, 95% CI 0.41-1.41) was not significantly associated with an OS benefit, as compared to no chemotherapy. Conclusion: Our study is the first to evaluate treatment specific outcomes in male patients with primary carcinoma of the urethra. We observed that neoadjuvant chemotherapy in men with UUC was associated with OS benefit. The utilization of NAC may improve survival, consistent with urothelial carcinoma of the bladder.
KW - Chemotherapy
KW - National cancer database
KW - Overall survival
KW - Primary urothelial carcinoma
KW - Urethral cancer
KW - Urethral Neoplasms/drug therapy
KW - Humans
KW - Male
KW - Urinary Bladder Neoplasms/drug therapy
KW - Carcinoma, Transitional Cell/drug therapy
KW - Cystectomy
KW - Neoadjuvant Therapy
KW - Retrospective Studies
KW - Chemotherapy, Adjuvant
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U2 - 10.1016/j.clgc.2022.01.011
DO - 10.1016/j.clgc.2022.01.011
M3 - Article
C2 - 35181268
AN - SCOPUS:85124650986
SN - 1558-7673
VL - 20
SP - 244
EP - 251
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 3
ER -