# Urothelial carcinoma of the urethra

Source: https://onco.cc/cancers/urethral-urothelial-carcinoma/  
OnCo record `urethral-urothelial-carcinoma` (Cancer). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Urothelial carcinoma of the urethra is the type of urethral cancer that grows from the same lining as bladder cancer, usually in the part of the urethra nearest the bladder or running through the prostate. It is treated by borrowing from bladder cancer: surgery, and chemotherapy with cisplatin before surgery when the disease is advanced.

## Summary

Primary urethral carcinoma is classified by the lining it arises from, and urothelial carcinoma arises in the proximal (bulbomembranous and prostatic) urethra in men and the proximal urethra in women, where the lining is urothelium continuous with the bladder (Gakis 2013). In the international collaboration on primary urethral carcinoma, 154 patients from ten referral centres between 1993 and 2012 had urothelial carcinoma in 47 percent, squamous cell carcinoma in 30 percent, adenocarcinoma in 11 percent and mixed or other histology in the rest; clinical nodal stage was the critical predictor of recurrence and survival (Gakis 2016). Two thirds of the patients in that series were men.

How it differs from its parent: the parent page covers all urethral cancers; this histology is the one closest to bladder cancer in behaviour and treatment, and it can be a first presentation of urothelial carcinoma of the prostatic ducts, which the EAU guideline treats with cystoprostatectomy pathways. A separate urethral urothelial carcinoma must also be distinguished from recurrence in the urethra after cystectomy for bladder cancer, which is staged as bladder disease.

How common: fewer than one case per million a year for all urethral cancer (parent page; Derksen 2013 gives 0.7 per million women in the Netherlands), and no registry counts the urothelial type alone.

Treatment follows the EAU guideline for the parent, with no randomised trial in this histology: urethra-sparing surgery for distal and superficial disease, and for locally advanced proximal disease cisplatin-based chemotherapy before surgery, borrowed from bladder cancer, with radiotherapy as an alternative; metastatic disease is treated as urothelial cancer of the bladder, so the enfortumab vedotin and pembrolizumab regimens linked from the parent page apply (EAU Guidelines: primary urethral carcinoma).

## Fields

- Kind: Cancer
- Last checked: 2026-09-24
- Also known as: Urethral urothelial carcinoma; Transitional cell carcinoma of the urethra; Urothelial carcinoma (proximal and prostatic urethra); Prostatic urethral carcinoma
- Tags: subtype-page; wave4; rare
- Group: genitourinary
- Burden: The commonest histology of primary urethral carcinoma: 72 of 154 patients (47 percent) in the international collaboration's ten-centre series, median age 66 (Gakis 2016). Urethral cancer as a whole affects about 650 people a year in the European Union (Visser 2012).
- Subtypes: Urothelial carcinoma of the prostatic urethra and ducts; Urothelial carcinoma of the bulbomembranous or proximal urethra; Urothelial carcinoma of the female proximal urethra
- Biomarkers: Clinical nodal stage (the strongest predictor in the international collaboration); Depth of invasion and location along the urethra; PD-L1, FGFR3 and nectin-4 as in bladder cancer, when systemic therapy is considered

## Sections of this record

The page is a hub with ten sections in reading order; large sections have their own page. The same plan as JSON: https://onco.cc/api/v1/cancers/urethral-urothelial-carcinoma/sections.json

- Overview (on the hub): The TL;DR, the family this cancer belongs to, the organ, who gets it and what the state of the art is. https://onco.cc/cancers/urethral-urothelial-carcinoma/#overview
- What it is (on the hub): Anatomy, the subtypes and how they differ, how it is staged, and where advanced disease spreads. https://onco.cc/cancers/urethral-urothelial-carcinoma/#what-it-is [3 subtypes]
- Finding it (on the hub): How it shows itself, how it is confirmed, what screening exists, and the biomarkers clinicians test for. https://onco.cc/cancers/urethral-urothelial-carcinoma/#finding-it [3 biomarkers]
- Treating it (on the hub): The standard of care by setting, the medicines, surgery and radiotherapy named in it, and the regimens behind them. https://onco.cc/cancers/urethral-urothelial-carcinoma/#treating-it [1 setting, 1 decision with options]
- Evidence (on the hub): Trials recruiting now, the landmark trials, the key papers and what they mean, the latest literature, and the milestones year by year. https://onco.cc/cancers/urethral-urothelial-carcinoma/#evidence
- The science (on the hub): The molecular landscape: the targets and how often each appears, the pathways, the mechanics stages and the preclinical models. https://onco.cc/cancers/urethral-urothelial-carcinoma/#science [2 targets]
- Where you are (own page): Cases by country, the UK and NHS pathway and other country lenses, and the expert centres with trials on record. https://onco.cc/cancers/urethral-urothelial-carcinoma/where-you-are/
- Living with it (on the hub): The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask. https://onco.cc/cancers/urethral-urothelial-carcinoma/#living-with-it [8 questions, 6 red cards]
- What is coming (own page): Everything in development, the open problems and what is being done about them, the roadmaps, and what changed on this record. https://onco.cc/cancers/urethral-urothelial-carcinoma/coming/ [4 medicines]
- Data (own page): Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked. https://onco.cc/cancers/urethral-urothelial-carcinoma/data/ [15 connected records]

## Standard of care

- All stages: Treated as the parent page describes, borrowing bladder cancer pathways: urethra-sparing surgery when distal, cisplatin-based chemotherapy before surgery or chemoradiation when locally advanced, bladder-cancer systemic therapy when metastatic. ([Urethral cancer](https://onco.cc/cancers/urethral/), [Bladder & urothelial cancer](https://onco.cc/cancers/urothelial/), [Gemcitabine + cisplatin](https://onco.cc/drugs/gemcitabine-cisplatin/), [Enfortumab vedotin](https://onco.cc/drugs/enfortumab-vedotin/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/))

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Urethral_cancer
- NCI PDQ: urethral cancer treatment: https://www.cancer.gov/types/urethral/patient/urethral-treatment-pdq
- EAU Guidelines: primary urethral carcinoma: https://uroweb.org/guidelines/primary-urethral-carcinoma
- Gakis 2013, European Urology: EAU guidelines on primary urethral carcinoma: https://doi.org/10.1016/j.eururo.2013.03.044
- Gakis 2016, World J Urol: international collaboration on primary urethral carcinoma, 154 patients: https://doi.org/10.1007/s00345-015-1583-7
- Visser 2012, Eur J Cancer: incidence and survival of rare urogenital cancers in Europe (RARECARE): https://doi.org/10.1016/j.ejca.2011.10.031

## Connected records

- cancers: [Adenocarcinoma of the urethra (including clear cell adenocarcinoma)](https://onco.cc/cancers/urethral-adenocarcinoma/), [Bladder & urothelial cancer](https://onco.cc/cancers/urothelial/), [Melanoma of the urethra](https://onco.cc/cancers/urethral-melanoma/), [Non-muscle-invasive bladder cancer](https://onco.cc/cancers/non-muscle-invasive-bladder-cancer/), [Squamous cell carcinoma of the urethra](https://onco.cc/cancers/urethral-squamous-cell-carcinoma/), [Urethral cancer](https://onco.cc/cancers/urethral/)
- targets: [Nectin-4](https://onco.cc/targets/nectin4/), [PD-1](https://onco.cc/targets/pd1/)
- terms: [FGFR3 alterations (bladder cancer)](https://onco.cc/terms/fgfr3/)
- drugs: [Cisplatin](https://onco.cc/drugs/cisplatin/), [Enfortumab vedotin](https://onco.cc/drugs/enfortumab-vedotin/), [Gemcitabine + cisplatin](https://onco.cc/drugs/gemcitabine-cisplatin/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/)

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JSON: https://onco.cc/api/v1/entities/urethral-urothelial-carcinoma.json