Oncological Outcomes of Patients with Concomitant Bladder and Urethral Carcinoma
Georgios Gakis1, Jason A Efstathiou, Siamak Daneshmand
1Department of Urology, University of Michigan, Ann Arbor, Mich., USA.
Introduction:
The study aimed to investigate oncological outcomes of patients with concomitant bladder cancer (BC) and urethral carcinoma.
Methods:
This is a multicenter series of 110 patients (74 men, 36 women) diagnosed with urethral carcinoma at 10 referral centers between 1993 and 2012. Kaplan-Meier analysis was used to investigate the impact of BC on survival, and Cox regression multivariable analysis was performed to identify predictors of recurrence.
Results:
Synchronous BC was diagnosed in 13 (12%) patients, and the median follow-up was 21 months (interquartile range 4-48). Urethral cancers were of higher grade in patients with synchronous BC compared to patients with non-synchronous BC (p = 0.020). Patients with synchronous BC exhibited significantly inferior 3-year recurrence-free survival (RFS) compared to patients with non-synchronous BC (63.2 vs. 34.4%; p = 0.026). In multivariable analysis, inferior RFS was associated with clinically advanced nodal stage (p < 0.001), proximal tumor location (p < 0.001) and synchronous BC (p = 0.020).
Conclusion:
The synchronous presence of BC in patients diagnosed with urethral carcinoma has a significant adverse impact on RFS and should be an impetus for a multimodal approach.
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