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26 terms

Urethral Cancer

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What are etiologic factors for male urethral cancer?
Chronic inflammation, urethral stricture, urethritis, STD (HPV-16)
What are presenting symptoms of male urethral cancer?
Urethral bleeding, palpable mass, obstructive voiding
Tumors in the bulbomembraneous urethra make up what % of male urethral cancer and are of what histologic subtype?
Overal 60%
SCC - 80%
TCC - 10%
Adeno - 10%
Tumors in the penile urethra make up what % of male urethral cancer and are of what histologic subtype?
Overall 30%
SCC - 90%
TCC - 90%
Tumors in the prostatic urethra make up what % of male urethral cancer and are of what histologic subtype?
Overall 10%
TCC - 90%
SCC - 10%
What nodes do anterior and posterior urethra drain to?
Ant - Sup and deep inguinal
Post - Pelvic nodes
Ta male urethral cancer is?
noninvasive papillary, polypoid, or verrucous
T2 male urethral cancer is?
Invades corpus spongiosum, prostate, or periurethral muscle
T3 male urethral cancer is?
Invades cavernosum, ant vagina, bladder neck, beyond prostate capsule
Describe the N staging for male urethral cancer
N1 - single node <2cm
N2 - single node 2-5 or multiple <5
N3 - node >5
Is ant or posterior urethral cancer more amenable to surgical resection?
Anterior
T/F prophylactic or early ILND has been shown to have benefit with anterior urethral cancer?
F - only indicated with palpable nodes
What is the incidence of urethral recurrence after cutaneous diversion?
2-11%
What is the incidence of urethral recurrence after orthotopic diversion?
0.5-4%
What are etiologies of female urethral cancer?
Leukoplakia, chronic irritation, caruncles, polyps, HPV
What percentage of female urethral cancer occurs in a diverticulum
5%
Higher incidence of adeno
What is the division of the female urethra?
Ant - distal 2/3 (can be excised without compromising continence)
Post - proximal 1/3
Female post urethral cancer primarily drains to what lymph nodes?
Ext iliac, then hypogastric and obturator
What is the histology of female urethral cancer?
SCC - 50-70%
Adeno - 25% (increased in urethral diverticulum)
TCC - 10%
T/F distal female urethral tumors have a better prognosis than proximal
T
What are prognostic factors for local control and survival of female urethral cancer?
Location and extent of primary tumor
T/F there is a survival benefit to prophylactic ILND for female urethral cancer
F
Treatment for female distal urethral cancer
Circumferential urethectomy
ILND if palp nodes
Treatment for female proximal urethral cancer
Anterior exent with PLND
Often multimodal therapy
Rad+Chemo(5-FU and MMC for SCC, MVAC for TCC) or Rad+surgery
What increases the likelihood of urethral cancer recurrence with a cutaneous diversion?
Prostatic stromal invasion
What is the only GU neoplasm that is more common in females than males?
Urethral cancer