Guidelines

Primary Urethral Carcinoma

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. When the first carcinoma in the urinary tract is detected in the urethra, this is defined as primary urethral carcinoma, in contrast to secondary urethral carcinoma, which presents as recurrent carcinoma in the urethra after prior diagnosis and treatment of carcinoma elsewhere in the urinary tract. Most often, secondary urethral carcinoma is reported after radical cystectomy for bladder cancer [1,2] (see Chapter 7.3 of the European Association of Urology [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, oncologists, a pathologist, a radiotherapist 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. In the course of 2021 two patient representatives have formally joined the MIBC Guidelines Panel. 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:
https://uroweb.org/guideline/primary-urethral-carcinoma/.

1.3. Available publications

A quick reference document (Pocket guidelines) is available in print and as an app for iOS and Android devices, presenting the main findings of the Primary Urethral Carcinoma Guidelines. These are abridged versions which may require consultation together with the full text version. The most recent scientific summary was published in 2020 [3].

1.4. Publication history & summary of changes

The Primary Urethral Carcinoma Guidelines were first published in 2013. This is the ninth update of this document.

1.4.1. Summary of changes

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

Section 6.3 Summary of evidence for prognosis

Summary of evidence

LE

In locally advanced urothelial and squamous cell carcinoma of the urethra, treatment in academic centres improves overall survival.

3

Section 7.3.6 Summary of evidence and guidelines for multimodal treatment in advanced urethral carcinoma in both males and females

Recommendation

Strength rating

Refer patients with advanced urethral carcinoma to academic centres.

Strong