Primary urethral carcinoma in females: an epidemiologic study on demographical factors, histological types, tumour stage and survival

To obtain insight into demographical factors, histology and survival rates of females diagnosed with primary urethral cancer and to determine favourable treatment. Data from 91 females with primary urethral carcinoma, age varying from 15 to 85 years, registered between 1989 and 2008 at the National Cancer Registry of the Netherlands were used for this study. Demographical factors, incidence rate, morphology and tumour stage according to TNM classification were analysed. Kaplan-Meier survival curves were constructed and stratified by stage, histological type and treatment modality. The overall crude annual incidence was 0.7 per million women with a peak incidence in the age group of 80-84 years. Analysis of the morphology showed urothelial cell carcinoma (UCC) in 45 %, squamous cell carcinoma (SCC) in 19 %, adenocarcinoma (AC) in 29 %, and unknown or undifferentiated carcinoma accounted for 6 %. Almost half of patients (46 %) had advanced disease at time of diagnosis and was mainly treated with surgery and/or radiotherapy. The 5-year survival rates of stage 0-II, stage III and stage IV were 67, 53 and 17 %, respectively. The 5-year survival rates of SCC, UCC and AC were 64, 61 and 31 %, respectively. Female primary urethral carcinoma is a rare condition, and the majority of patients were aged above 65 years. Almost half of patients have advanced disease upon diagnosis. TNM stage and histological type of disease are the most determining factors for survival. Extended surgery with or without radiotherapy seems to be the most favourable treatment. Awareness and early diagnosis are important to improve survival.