Merck Manual

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Urethral Cancer

By

Thenappan Chandrasekar

, MD, University of California, Davis

Reviewed/Revised Oct 2023
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Urethral cancer is rare and occurs in both sexes; it may be squamous or transitional cell carcinoma or, occasionally, adenocarcinoma.

Most patients are aged 50. Certain strains of human papillomavirus Human Papillomavirus (HPV) Infection Human papillomavirus (HPV) infects epithelial cells. Most of the > 100 subtypes infect cutaneous epithelium and cause skin warts; some types infect mucosal epithelium and cause anogenital warts... read more Human Papillomavirus (HPV) Infection have been implicated in certain cases. Urethral tumors invade adjacent structures early and thus tend to be advanced when diagnosed. External groin or pelvic (obturator) lymph nodes are usually the first sites of metastasis.

Symptoms and Signs of Urethral Cancer

Diagnosis of Urethral Cancer

Treatment of Urethral Cancer

  • Usually excision or ablation

For superficial or minimally invasive distal tumors in the anterior urethra, treatment is with surgical excision, radiation therapy (interstitial or a combination of interstitial and external beam), fulguration, or laser ablation. Larger and more deeply invasive anterior tumors and proximal tumors in the posterior urethra require multimodal therapy with radical surgery and urinary diversion, usually in combination with chemotherapy and radiation therapy. Surgery includes bilateral pelvic and sometimes inguinal lymph node dissection, often with removal of part of the symphysis pubis and inferior pubic rami.

Prognosis for Urethral Cancer

Prognosis depends on the precise location in the urethra and extent of the cancer, particularly depth of invasion. The 5-year survival rates are > 60% for patients with distal tumors and 10 to 20% for patients with proximal tumors. Recurrence rate is >50%.

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