Marissa Kent1, Leonard Zinman1, Lyubov Girshovich2, Jacob Sands3, Alex Vanni1. 1. Department of Urology, Lahey Hospital and Medical Center, Burlington, Massachusetts. 2. Department of Radiation Oncology, Lahey Hospital and Medical Center, Burlington, Massachusetts. 3. Department of Oncology, Lahey Hospital and Medical Center, Burlington, Massachusetts.
Abstract
PURPOSE: We evaluated the efficacy and intermediate term outcomes of a combined chemoradiation protocol for the treatment of primary invasive carcinoma of the male urethra. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 29 male patients diagnosed with carcinoma of the urethra between 1991 and 2014. All patients were treated at the same tertiary care referral center, and received a combination chemoradiation protocol consisting of 2 cycles of 5-fluorouracil and mitomycin-C with concurrent external beam radiation therapy to the genitalia, perineum, and inguinal and external iliac lymph nodes. Kaplan-Meier curves were constructed to assess overall, disease specific and disease-free survival. RESULTS: A total of 26 patients met inclusion criteria for the study. Median followup was 35.5 months. The histology was squamous cell carcinoma in all but 1 patient with adenocarcinoma. Overall 88% of patients presented with at least T3 disease or metastatic to the lymph nodes and only 10% presented with a well differentiated tumor. Nineteen (79%) patients showed complete response to treatment. Five patients (21%) had no response to treatment and ultimately died of their disease, regardless of salvage therapy. Of the 19 complete responders 8 (42%) had disease recurrence at a median of 12.5 months. The 5-year overall, disease specific and disease-free survival rates were 52% (SE 10.6%), 68.4% (SE 10%) and 43.2% (SE 10.2%), respectively. CONCLUSIONS: Male squamous cell carcinoma treated with combination chemoradiation offers the potential for genital preservation and is an alternative therapeutic choice in patients not seeking surgery or considered surgical candidates.
PURPOSE: We evaluated the efficacy and intermediate term outcomes of a combined chemoradiation protocol for the treatment of primary invasive carcinoma of the male urethra. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 29 male patients diagnosed with carcinoma of the urethra between 1991 and 2014. All patients were treated at the same tertiary care referral center, and received a combination chemoradiation protocol consisting of 2 cycles of 5-fluorouracil and mitomycin-C with concurrent external beam radiation therapy to the genitalia, perineum, and inguinal and external iliac lymph nodes. Kaplan-Meier curves were constructed to assess overall, disease specific and disease-free survival. RESULTS: A total of 26 patients met inclusion criteria for the study. Median followup was 35.5 months. The histology was squamous cell carcinoma in all but 1 patient with adenocarcinoma. Overall 88% of patients presented with at least T3 disease or metastatic to the lymph nodes and only 10% presented with a well differentiated tumor. Nineteen (79%) patients showed complete response to treatment. Five patients (21%) had no response to treatment and ultimately died of their disease, regardless of salvage therapy. Of the 19 complete responders 8 (42%) had disease recurrence at a median of 12.5 months. The 5-year overall, disease specific and disease-free survival rates were 52% (SE 10.6%), 68.4% (SE 10%) and 43.2% (SE 10.2%), respectively. CONCLUSIONS:Male squamous cell carcinoma treated with combination chemoradiation offers the potential for genital preservation and is an alternative therapeutic choice in patients not seeking surgery or considered surgical candidates.
Authors: Roy Mano; Emily A Vertosick; Joseph Sarcona; Daniel D Sjoberg; Nicole E Benfante; Timothy F Donahue; Harry W Herr; S Machele Donat; Bernard H Bochner; Guido Dalbagni; Alvin C Goh Journal: BJU Int Date: 2020-06-04 Impact factor: 5.588
Authors: Giuseppe Lucarelli; Marco Spilotros; Antonio Vavallo; Silvano Palazzo; Carlos Miacola; Saverio Forte; Matteo Matera; Marcello Campagna; Ottavio Colamonico; Francesco Schiralli; Francesco Sebastiani; Federica Di Cosmo; Carlo Bettocchi; Giuseppe Di Lorenzo; Carlo Buonerba; Leonardo Vincenti; Giuseppe Ludovico; Pasquale Ditonno; Michele Battaglia Journal: Medicine (Baltimore) Date: 2016-05 Impact factor: 1.889
Authors: Isabelle Antwerpen; Lukas Gstrein; Linda Moskovszky; Hans Martin Gissler; Tilmann Möltgen; Maciej Kwiatkowski; Stephen Wyler; Matthias Walter Journal: J Int Med Res Date: 2018-12-05 Impact factor: 1.671
Authors: Mike Wenzel; Marina Deuker; Luigi Nocera; Claudia Collà Ruvolo; Zhe Tian; Shahrokh F Shariat; Fred Saad; Alberto Briganti; Andreas Becker; Luis A Kluth; Felix K H Chun; Pierre I Karakiewicz Journal: Front Oncol Date: 2021-01-29 Impact factor: 6.244