Urethral cancer natural history, complications, and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Vindhya BellamKonda, M.B.B.S [2]

Overview

Common complications of urethral cancer include metastasis, anemia, hydronephrosis, urethral stricture, and urinary incontinence. The prognosis of urethral cancer varies with the depth of invasion, anatomical location, size, and stage of tumor. Superficial tumors located in the distal urethra have the most favorable prognosis.

Natural History

• The symptoms of Urethral cancer usually develop in the 6th and 7th decade of life, and start with symptoms such as hematuria, difficulty urinating and dysuria.

Complications

• Common complications of urethral cancer include:

• Anemia
• Hydronephrosis
• Urethral stricture
• Urinary incontinence
• Urinary retention
• Ureteral obstruction
• Lymphadenopathy in the groin and vaginal area

Prognosis

• The prognosis of urethral cancer depends on the following factors:

• Anatomical location
• Size
• Stage
• Depth of invasion

• Superficial tumors located in the distal urethra of both the female and male are generally curable. However, deeply invasive lesions are rarely curable by any combination of therapies.
• In men, the prognosis of tumors in the distal (pendulous) urethra is better than for tumors of the proximal (bulbomembranous) and prostatic urethra, which tend to present at more advanced stages.
• Distal urethral tumors tend to occur at earlier stages in women, and they appear to have a better prognosis than proximal tumors.
• Lesions of the proximal or entire length of the urethra are usually associated with invasion and a high incidence of pelvic nodal metastases with 5-year survival rates ranging from 10% to 20%.