Treatment of Primary Urethral Carcinoma of the Proximal Urethra (Non-Prostatic), Stage Ta–T2, N0, M0
Clinical Scenario
This protocol applies to patients with primary urethral carcinoma of the proximal urethra (non-prostatic) at stages Ta through T2, without regional nodal involvement (N0) and without distant metastasis (M0). Proximal tumour location carries recognised prognostic significance: distal urethral tumours exhibit significantly improved survival rates compared with proximal tumours.
Surgical Management (Partial Overview)
Treatment is centred on a surgical approach targeting complete local control, with rigorous attention to circumferential margin status. For more advanced localised disease, evaluation of regional lymph nodes forms part of the surgical decision-making.
References
Distal urethral tumours exhibit significantly improved survival rates compared with proximal tumours.
To provide the highest chance of local cure in females with localised urethral carcinoma, primary radical urethrectomy should include removal of all the periurethral tissue from the bulbocavernosus muscle, bilaterally and distally, with a cylinder of all adjacent soft tissue up to the pubic symphysis and bladder neck.
Offer radical urethrectomy unless specific criteria for organ preservation are met.
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