BACKGROUND: To evaluate the impact of salvage therapy (ST) on overall survival (OS) in recurrent primary urethral cancer (PUC). PATIENTS: A series of 139 patients (96 men, 43 women; median age = 66, interquartile range: 57-77) were diagnosed with PUC at 10 referral centers between 1993 and 2012. The modality of ST of recurrence (salvage surgery vs. radiotherapy) was recorded. Kaplan-Meier analysis with log-rank was used to estimate the impact of ST on OS (median follow-up = 21, interquartile range: 5-48). RESULTS: The 3-year OS for patients free of any recurrence (I), with solitary or concomitant urethral recurrence (II), and nonurethral recurrence (III) was 86.5%, 74.5%, and 48.2%, respectively (P = 0.002 for I vs. III and II vs. III; P = 0.55 for I vs. II). In the 80 patients with recurrences, the modality of primary treatment of recurrence was salvage surgery in 30 (37.5%), salvage radiotherapy (RT) in 8 (10.0%), and salvage surgery plus RT in 5 (6.3%) whereas 37 patients did not receive ST for recurrence (46.3%). In patients with recurrences, those who underwent salvage surgery or RT-based ST had similar 3-year OS (84.9%, 71.6%) compared to patients without recurrence (86.7%, P = 0.65), and exhibited superior 3-year OS compared to patients who did not undergo ST (38.0%, P<0.001 compared to surgery, P = 0.045 to RT-based ST, P = 0.29 for surgery vs. RT-based ST). CONCLUSIONS: In this study, patients who underwent ST for recurrent PUC demonstrated improved OS compared to those who did not receive ST and exhibited similar survival to those who never developed recurrence after primary treatment.

Department of Urology 2nd Medical School Charles University Prague Czech Republic

Department of Urology Julius Maximillians University Würzburg Germany

Department of Urology University Hospital Bern Switzerland

Department of Urology University Hospital Regensburg Regensburg Germany

Department of Urology University Medical Center Hamburg Eppendorf Hamburg Eppendorf Germany

Department of Urology University of Michigan Ann Arbor MI

Department of Urology University of Tübingen Tübingen Germany

Department of Urology University of Tübingen Tübingen Germany; Department of Urology Julius Maximillians University Würzburg Germany

Institute of Urology USC Norris Comprehensive Cancer Center Los Angeles CA

Mansoura Clinic Urology and Nephrology Center Mansoura Egypt

Massachusetts General Hospital Harvard Medical School Boston MA

Vanderbilt University Medical Center Department of Urologic Surgery Nashville TN

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