Review on urethral cancer: what do you need to know

Abstract

Urethral cancer is an extremely rare malignancy accounting for less than 1% of all malignancies. Most current literature involves retrospective studies with small sample sizes, so indications for treatment methodologies are not intuitive. The difficulty of treating this disease starts at diagnosis. Proximal (posterior) tumors are sometimes missed until later stage disease since they are difficult to palpate on physical exam. Early stage distal tumors are also sometimes misdiagnosed as infection which may delay treatment and worsen prognosis. MRI remains the standard for imaging urethral carcinomas. Multimodal therapy has shown benefit to treating advanced stage disease, whereas surgery alone is often sufficient to treating early stage disease. Salvage therapy has similar prognosis to first-line therapy in treating urethral cancer. A limitation to drawing conclusions on the best treatment modality for urethral cancer in this review pertains to the lack of prospective studies available. Additional studies with more standardized patient therapeutic approaches preferably a prospective randomized control setting are needed to guide evidence based treatment approaches moving forward.