The epidemiology and role of surgery in the treatment of urethral clear cell carcinoma.

Purpose: To perform a retrospective analysis of the epidemiology and role of surgery on survival in patients with urethral clear cell carcinoma (UCCC) using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database.

Methods: UCCC cases diagnosed from January 1, 1973, to December 31, 2014, were extracted from SEER. Descriptive statistics were calculated for all variables. Univariate analysis to assess for differences in survival with respect to covariates was performed using the log-rank test. Multivariate analysis was performed with Cox proportional hazards regression models to determine the predictive performance of covariates with respect to overall survival (OS) and disease-specific survival (DSS), reported as hazard ratio (HR) with 95% CIs. Comparisons were considered statistically significant at P < 0.05.

Results: Sixty-one cases were extracted for analysis. Mean age ± SD was 63.0 ± 13.9 years. Fifty (82%), 18 (29.5%), and 14 (23.0%) patients underwent surgery, radiation, and chemotherapy, respectively. On univariate analysis, the following covariates were associated with both OS and DSS: age, stage, and surgery (all P < 0.001). On multivariate analysis, surgery was a predictor for improved OS and DSS (HR, 0.178; 95% CI [0.068; 0.464]) and HR, 0.166; 95% CI [0.057; 0.484], respectively). Neither radiation nor chemotherapy was significantly associated with OS or DSS.

Conclusion: Surgery was associated with improved OS and DSS in patients with UCCC. While neither radiation nor chemotherapy was significantly associated with survival, additional studies are necessary to determine how these therapeutic interventions may impact prognosis.