Survival rates in primary urethral cancer: systematic review and meta-analysis

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Abstract

Background. Primary urethral carcinoma is a rare and aggressive malignancy of the genitourinary system characterized by significant heterogeneity and limited high-quality evidence.

Aim. To summarize survival outcomes and identify key prognostic factors.

Materials and methods. A comprehensive search of PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and eLibrary was performed according to PRISMA 2020 guidelines. Eligible studies (2000–2025) included ≥5 patients with primary urethral cancer and reported overall (OS) and/or cancer-specific survival (CSS). Thirty studies (n = 12,215) met the inclusion criteria. A random-effects meta-analysis was conducted.

Results. The pooled 5-year OS was 44.8 % (95 % confidence interval 41.5–48.1, I2 = 74 %), while 5-year CSS was approximately 51.5 % (95 % confidence interval 45.8–57.2, I2 = 88.7 %). Localized disease showed markedly better outcomes, with OS reaching 60–70 % in non-metastatic cases. Regional nodal involvement reduced survival to 30–40 %, and distant metastases to < 10 %. Radical surgery (partial/total urethrectomy and possible lymph node dissection) was associated with a 50–60 % reduction in mortality compared to non-surgical management. Histological subtype impacted prognosis: urothelial and squamous cell carcinomas showed comparable outcomes, whereas adenocarcinoma and melanoma demonstrated significantly poorer CSS.

Conclusion. Findings emphasize the critical importance of early detection and radical surgical treatment. High rates of local recurrence after organ-sparing approaches highlight the need for multimodal therapy. Despite advances in combined treatment strategies, long-term outcomes remain suboptimal, supporting further research into optimized therapeutic sequencing and novel systemic agents.

About the authors

Vladimir A. Vorobev

Bashkir State Medical University, Ministry of Health of Russia; Irkutsk State Medical University, Ministry of Health of Russia

Author for correspondence.
Email: denecer@yandex.ru
ORCID iD: 0000-0003-3285-5559
Russian Federation, 3 Lenina St., Ufa 450008; 1 Krasnogo Vosstaniya St., Irkutsk 664003

A. A. Izmailov

Bashkir State Medical University, Ministry of Health of Russia; Republican Clinical Oncology Dispensary

Email: denecer@yandex.ru
ORCID iD: 0000-0002-8461-9243
Russian Federation, 3 Lenina St., Ufa 450008; 73/1 Prospekt Oktyabrya, Ufa 450054

A. R. Farganov

Republican Clinical Oncology Dispensary, Republic of Bashkortostan

Email: denecer@yandex.ru
ORCID iD: 0009-0005-4019-9602
Russian Federation, 73/1 Prospekt Oktyabrya, Ufa 450054

K. M. Su-Yanz

Irkutsk State Medical University, Ministry of Health of Russia

Email: denecer@yandex.ru
ORCID iD: 0009-0005-9143-916X
Russian Federation, 1 Krasnogo Vosstaniya St., Irkutsk 664003

A. I. Syrova

Irkutsk State Medical University, Ministry of Health of Russia

Email: denecer@yandex.ru
ORCID iD: 0009-0003-0616-3257
Russian Federation, 1 Krasnogo Vosstaniya St., Irkutsk 664003

A. I. Syrova

Irkutsk State Medical University, Ministry of Health of Russia

Email: denecer@yandex.ru
ORCID iD: 0009-0001-9400-1738
Russian Federation, 1 Krasnogo Vosstaniya St., Irkutsk 664003

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