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• W2005954746 abstract "No AccessJournal of UrologyAdult urology1 Feb 2008Coordinated Chemoradiation Therapy With Genital Preservation for the Treatment of Primary Invasive Carcinoma of the Male Urethra Michael S. Cohen, Veronica Triaca, Brian Billmeyer, Robert S. Hanley, Lyubov Girshovich, Todd Shuster, Richard A. Oberfield, and Leonard Zinman Michael S. CohenMichael S. Cohen Department of Urology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author , Veronica TriacaVeronica Triaca Department of Urology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author , Brian BillmeyerBrian Billmeyer Department of Urology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author , Robert S. HanleyRobert S. Hanley Department of Urology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author , Lyubov GirshovichLyubov Girshovich Department of Radiation Oncology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author , Todd ShusterTodd Shuster Department of Oncology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author , Richard A. OberfieldRichard A. Oberfield Department of Oncology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author , and Leonard ZinmanLeonard Zinman Department of Urology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2007.09.068AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the efficacy of a combined chemoradiation therapy protocol for the primary treatment of primary invasive carcinoma of the male urethra. Materials and Methods: From January 1991 to December 2006, 18 patients with invasive carcinoma of the male urethra referred to our institution were treated with a chemoradiation therapy protocol, consisting of 2 cycles of 5-fluorouracil (1,000 mg/m2) on days 1 to 4 and days 29 to 32, and mitomycin-C (10 mg/m2) on days 1 and 29 with concurrent external beam radiation therapy (45 to 55 Gy in 25 fractions during 5 weeks) to the genitalia, perineum, and inguinal and external iliac lymph nodes. Kaplan-Meier curves were constructed to assess overall, disease specific and disease-free survival. Results: The stage and node distribution was T2N0 in 2 patients (11%), T3N0 in 8 (44%), T4N0 in 2 (11%), TXN1 in 1(6%) and TXN2 in 5 (28%). The most prevalent histology was moderately (7 of 18 patients or 39%) or poorly (10 of 18 or 56%) differentiated squamous cell carcinoma (17 of 18 or 95%). Overall 83% (15 of 18) of the patients had a complete response to the primary chemoradiation therapy protocol, and the 5-year overall and disease specific survival rates were 60% and 83%, respectively. Five-year disease-free survival rates after chemoradiation therapy and after chemoradiation therapy with salvage surgery were 54% and 72%, respectively. The 3 nonresponders died of disease after undergoing salvage surgery and 5 of the 15 complete responders (30%) had recurrence. Complex urethral reconstruction was required in 3 of 10 patients (30%) who had prolonged disease-free survival. Conclusions: The chemoradiation therapy protocol is an alternative primary treatment modality for invasive urethral carcinoma. It enables an unprecedented potential for organ preservation. References 1 : Male urethral carcinoma: analysis of treatment outcome. Urology1999; 53: 1126. Google Scholar 2 : Therapy and prognosis for male anterior urethral carcinoma: an update. Urology1994; 43: 506. 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Google Scholar 18 : Surgical treatment of carcinoma of the male urethra. Urol Clin North Am1992; 19: 359. Google Scholar 19 : Chemotherapy with cisplatin and 5-fluorouracil for penile and urethral squamous cell carcinomas. Cancer1990; 65: 433. Google Scholar 20 : Carcinoma of male urethra: management of locally advanced disease with combined chemotherapy, radiotherapy, and penile-preserving surgery. Urology1992; 39: 21. Google Scholar © 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byKent M, Zinman L, Girshovich L, Sands J and Vanni A (2018) Combined Chemoradiation as Primary Treatment for Invasive Male Urethral CancerJournal of Urology, VOL. 193, NO. 2, (532-537), Online publication date: 1-Feb-2015. Volume 179Issue 2February 2008Page: 536-541 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordscarcinomasquamous cellradiotherapydrug therapyurethraneoplasm invasivenessMetrics Author Information Michael S. Cohen Department of Urology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author Veronica Triaca Department of Urology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author Brian Billmeyer Department of Urology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author Robert S. Hanley Department of Urology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author Lyubov Girshovich Department of Radiation Oncology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author Todd Shuster Department of Oncology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author Richard A. Oberfield Department of Oncology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author Leonard Zinman Department of Urology, Lahey Clinic Medical Center, Burlington, Massachusetts More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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