Primary Urethral Carcinoma

Full Text Guidelines Summary of Changes Scientific Publications & Appendices Archive Panel

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G. Gakis, J.A. Witjes, M. Bruins, E. Compérat, N.C. Cowan, V. Hernàndez, T. Lebret, A. Lorch, M.J. Ribal, A.G. van der Heijden, E. Veskimäe
Guidelines Associates: M.E. Linares Espinós, M. Rouanne, Y. Neuzillet

1.INTRODUCTION

1.1.Aims and scope

The aim of these guidelines is to deliver current evidence-based information on the diagnosis and treatment of patients with primary urethral carcinoma (UC). When the first carcinoma in the urinary tract is detected in the urethra, this is defined as primary UC, in contrast to secondary UC, which presents as recurrent carcinoma in the urethra after prior diagnosis and treatment of carcinoma elsewhere in the urinary tract. Most often, secondary UC is reported after radical cystectomy for bladder cancer [1,2] (see Chapter 7.4 of the EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer [MIBC] [2]).

It must be emphasised that clinical guidelines present the best evidence available to the experts but following guideline recommendations will not necessarily result in the best outcome. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions - also taking personal values and preferences/individual circumstances of patients into account.

Guidelines are not mandates and do not purport to be a legal standard of care.

1.2.Panel composition

The EAU Guidelines Panel on MIBC is responsible for this publication. This is an international multidisciplinary group of clinicians, including urologists, a pathologist, an oncologist and a radiologist. Members of this panel have been selected based on their expertise to represent the professionals treating patients suspected of suffering from urethral carcinoma. All experts involved in the production of this document have submitted potential conflict of interest statements, which can be viewed on the EAU Website Uroweb: http://www.uroweb.org/guidelines/primary-urethral-carcinoma/.

1.3.Publication history and summary of changes

The Primary Urethral Carcinoma Guidelines were first published in 2013 [3]. This is the fourth update of this document.

1.3.1.Summary of changes

The literature for the complete document has been assessed and updated, where relevant.

A text section has been added:

  • Section 7.3.3 - Salvage treatment in recurrent primary urethral carcinoma after surgery for primary treatment

New recommendations have been added to:

  • Section 7.1.1 - Summary of evidence and guidelines for the treatment of primary urethral carcinoma in males

Recommendation

LE

Strength rating

Ensure complete circumferential assessment of the proximal urethral margin if penis-preserving surgery is intended.

3

Strong

  • Section 7.3.5 - Summary of evidence and guidelines for multimodal treatment in advanced urethral carcinoma in both genders

Recommendations

LE

Strength rating

Systemic therapy in advanced disease should be selected based upon histology of the tumour.

3

Strong

Offer salvage surgery or radiotherapy to patients with urethral recurrence after primary treatment.

3

Strong

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