Urethral cancer

INTRODUCTION

1.Which are the causes and the symptoms of urethral cancer?
2.Istological features
3.Surgical treatment of urethral cancer
4.Some data published in the literature

1.Which are the causes and the symptoms of urethral cancer?

Urethral cancer is a rare patology.
Average age of onset is 60-70 years, even though the literature describes cases between 13 and 90 years of age.
 

The causes are:

  • cronic urethral infections
  • urethral stricture disease cause from 24% to 76% of urethral cancer
  • urethral trauma
  • cyclic urethral dilatations

The symptoms are the same as those of a simple benign urethral stricture.
  • 60% of cases in the membranous urethra
  • 30 % of cases in the penile urethra
  • 10% of cases in the prostatic urethra

 

 

2.Istological features

  • 80% carcinoma with squamous cells
  • 15% carcinoma with transitional cells
  • 5% adenocarcinoma
  • Indifferentiated rare cancer

 


3.Surgical treatment of urethral cancer

Urethral cancer is a very aggressive pathology.

The treatment is a large surgical excision:

  • up to a margin of 2 cm from the tumor tor front urethral cancer
  • radical surgery ( radical cistoprostatectomy with pelvic lymphadenectomy and total penectomy) for rear urethral cancer
  • few data in literature have recorded the success of conservative treatment (local tumor excision,  electrocution; transurethral resection) in patient that could not underco radical surgery due to the presence of other associated pathologies or in patients with low grade and low stage cancer.

 

 

4.Some data published in the literature:

  • conservation of the penis has been described in relation to 3 patients with squamous cell urethral cancer in a low-medium stage.
  • Chemiotherapy : few studies have been done on  few patients with squamous urethral carcinoma.
  • Chemiotherapy + radiotherapy have been used for squamous cell carcinoma in a randomized perspective study.

It would be necessary to have studies made in several centres in order to  have many patients to complete the research.

  • radiotherapy presenves the penis but can cause urethral strictures and chronic edema. Moreover it does not prevent cancer relapse.