TITLE:
Multimodal Treatment Approach to Advanced Female Urethral Squamous Cell Carcinoma
AUTHORS:
Lindsay L. Hertzig, Richard C. Choo, Deborah J. Lightner, R. Jeffrey Karnes
KEYWORDS:
Squamous Cell Carcinoma; Urethral Carcinoma
JOURNAL NAME:
Open Journal of Urology,
Vol.2 No.3,
August
29,
2012
ABSTRACT: Introduction and Objectives: Primary squamous cell carcinoma of the female urethra is rare. Given the small number of cases seen, no uniform regimen for optimal treatment has been identified. We set out to review the outcomes of women with advanced urethral squamous cell carcinoma treated with a multimodality approach in order to gain insight into the optimal treatment of this rare malignancy. Methods: We identified five women with advanced urethral squamous cell carcinoma treated by a single surgeon (RJK). After obtaining IRB approval, a retrospective chart review was performed and treatment strategies and outcomes were analyzed. Results: We report on 5 cases of squamous cell carcinoma of the female urethra treated utilizing a multimodal approach. Surgical therapy included anterior exenteration in two patients, partial urethrectomy in two patients and transurethral resection in one. Patients were treated with radiation in a neoadjuvant (2 cases), adjuvant (2 cases), or definitive (1 case) fashion. Four of five patients received chemotherapy. With a mean follow-up of 39 months (range 3 to 50), 4 patients remain without evidence of disease while one patient developed lung metastases 33 months after treatment. None had a locoregional tumor recurrence. Conclusion: Multi-modality approach combining surgery, radiotherapy, and chemotherapy can be effective therapeutic intervention for locally advanced, squamous cell carcinoma of the female urethra. For patients who have a significant surgical risk or desire to pursue an organ-preservation strategy, a trimodality approach of limited surgical excision combined with radiotherapy plus chemotherapy may be a reasonable alternative to anterior pelvic exenteration.