Mike Wenzel1,2, Marina Deuker1,2, Luigi Nocera2,3, Claudia Collà Ruvolo2,4, Zhe Tian2, Shahrokh F Shariat5,6,7,8,9,10, Fred Saad2, Alberto Briganti3, Andreas Becker1, Luis A Kluth1, Felix K H Chun1, Pierre I Karakiewicz2. 1. Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany. 2. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada. 3. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IBCAS San Raffaele Scientific Institute, Milan, Italy. 4. Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy. 5. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 6. Departments of Urology, Weill Cornell Medical College, New York, NY, United States. 7. Department of Urology, University of Texas Southwestern, Dallas, TX, United States. 8. Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czechia. 9. Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia. 10. Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.
Abstract
BACKGROUND: To test the effect of variant histology relative to urothelial histology on stage at presentation, cancer specific mortality (CSM), and overall mortality (OM) after chemotherapy use, in urethral cancer. MATERIALS AND METHODS: Within the Surveillance, Epidemiology and End Results (2004-2016) database, we identified 1,907 primary variant histology urethral cancer patients. Kaplan-Meier plots, Cox regression analyses, cumulative incidence-plots, multivariable competing-risks regression models and propensity score matching for patient and tumor characteristics were used. RESULTS: Of 1,907 eligible urethral cancer patients, urothelial histology affected 1,009 (52.9%) vs. squamous cell carcinoma (SCC) 455 (23.6%) vs. adenocarcinoma 278 (14.6%) vs. other histology 165 (8.7%) patients. Urothelial histological patients exhibited lower stages at presentation than SCC, adenocarcinoma or other histology patients. In urothelial histology patients, five-year CSM was 23.5% vs. 34.4% in SCC [Hazard Ratio (HR) 1.57] vs. 40.7% in adenocarcinoma (HR 1.69) vs. 43.4% in other histology (HR 1.99, p < 0.001). After matching in multivariate competing-risks regression models, variant histology exhibited 1.35-fold higher CSM than urothelial. Finally, in metastatic urethral cancer, lower OM was recorded after chemotherapy in general, including metastatic adenocarcinoma and other variant histology subtypes, except metastatic SCC. CONCLUSION: Adenocarcinoma, SCC and other histology subtypes affect fewer patients than urothelial histology. Presence of variant histology results in higher CSM. Finally, chemotherapy for metastatic urethral cancer improves survival in adenocarcinoma and other variant histology subtypes, but not in SCC.
BACKGROUND: To test the effect of variant histology relative to urothelial histology on stage at presentation, cancer specific mortality (CSM), and overall mortality (OM) after chemotherapy use, in urethral cancer. MATERIALS AND METHODS: Within the Surveillance, Epidemiology and End Results (2004-2016) database, we identified 1,907 primary variant histology urethral cancer patients. Kaplan-Meier plots, Cox regression analyses, cumulative incidence-plots, multivariable competing-risks regression models and propensity score matching for patient and tumor characteristics were used. RESULTS: Of 1,907 eligible urethral cancer patients, urothelial histology affected 1,009 (52.9%) vs. squamous cell carcinoma (SCC) 455 (23.6%) vs. adenocarcinoma 278 (14.6%) vs. other histology 165 (8.7%) patients. Urothelial histological patients exhibited lower stages at presentation than SCC, adenocarcinoma or other histology patients. In urothelial histology patients, five-year CSM was 23.5% vs. 34.4% in SCC [Hazard Ratio (HR) 1.57] vs. 40.7% in adenocarcinoma (HR 1.69) vs. 43.4% in other histology (HR 1.99, p < 0.001). After matching in multivariate competing-risks regression models, variant histology exhibited 1.35-fold higher CSM than urothelial. Finally, in metastatic urethral cancer, lower OM was recorded after chemotherapy in general, including metastatic adenocarcinoma and other variant histology subtypes, except metastatic SCC. CONCLUSION: Adenocarcinoma, SCC and other histology subtypes affect fewer patients than urothelial histology. Presence of variant histology results in higher CSM. Finally, chemotherapy for metastatic urethral cancer improves survival in adenocarcinoma and other variant histology subtypes, but not in SCC.
Authors: Marina Deuker; L Franziska Stolzenbach; Giuseppe Rosiello; Stefano Luzzago; Thomas Martin; Zhe Tian; Derya Tilki; Shahrokh F Shariat; Fred Saad; Wassim Kassouf; Peter C Black; Felix K H Chun; Pierre I Karakiewicz Journal: Eur J Surg Oncol Date: 2020-05-12 Impact factor: 4.424
Authors: G Gakis; T M Morgan; S Daneshmand; K A Keegan; T Todenhöfer; J Mischinger; T Schubert; H B Zaid; J Hrbacek; B Ali-El-Dein; R H Clayman; S Galland; K Olugbade; M Rink; H-M Fritsche; M Burger; S S Chang; M Babjuk; G N Thalmann; A Stenzl; J A Efstathiou Journal: Ann Oncol Date: 2015-05-12 Impact factor: 32.976
Authors: Georgios Gakis; J Alfred Witjes; Eva Compérat; Nigel C Cowan; Maria De Santis; Thierry Lebret; Maria J Ribal; Amir M Sherif Journal: Eur Urol Date: 2013-04-02 Impact factor: 20.096
Authors: Evanguelos Xylinas; Michael Rink; Brian D Robinson; Yair Lotan; Marek Babjuk; Antonin Brisuda; David A Green; Luis A Kluth; Armin Pycha; Yves Fradet; Talia Faison; Richard K Lee; Pierre I Karakiewicz; Marc Zerbib; Douglas S Scherr; Shahrokh F Shariat Journal: Eur J Cancer Date: 2013-03-04 Impact factor: 9.162
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: Colin E Champ; Sarah E Hegarty; Xinglei Shen; Mark V Mishra; Adam P Dicker; Edouard J Trabulsi; Costas D Lallas; Leonard G Gomella; Terry Hyslop; Timothy N Showalter Journal: Urology Date: 2012-08 Impact factor: 2.649
Authors: Mike Wenzel; Luigi Nocera; Claudia Collà Ruvolo; Christoph Würnschimmel; Zhe Tian; Shahrokh F Shariat; Fred Saad; Alberto Briganti; Derya Tilki; Philipp Mandel; Andreas Becker; Luis A Kluth; Felix K H Chun; Pierre I Karakiewicz Journal: Cancer Causes Control Date: 2021-03-22 Impact factor: 2.506
Authors: Mike Wenzel; Nicolas Siron; Claudia Collà Ruvolo; Luigi Nocera; Christoph Würnschimmel; Zhe Tian; Shahrokh F Shariat; Fred Saad; Alberto Briganti; Derya Tilki; Severine Banek; Luis A Kluth; Frederik C Roos; Felix K H Chun; Pierre I Karakiewicz Journal: Cancer Causes Control Date: 2021-09-02 Impact factor: 2.506