{"entity":{"id":"urethral-urothelial-carcinoma","kind":"cancer","name":"Urothelial carcinoma of the urethra","aka":["Urethral urothelial carcinoma","Transitional cell carcinoma of the urethra","Urothelial carcinoma (proximal and prostatic urethra)","Prostatic urethral carcinoma"],"tldr":"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.\n\nHow 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.\n\nHow 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.\n\nTreatment 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).","asOf":"2026-09-24","wikipedia":"https://en.wikipedia.org/wiki/Urethral_cancer","links":[{"label":"NCI PDQ: urethral cancer treatment","url":"https://www.cancer.gov/types/urethral/patient/urethral-treatment-pdq"},{"label":"EAU Guidelines: primary urethral carcinoma","url":"https://uroweb.org/guidelines/primary-urethral-carcinoma"},{"label":"Gakis 2013, European Urology: EAU guidelines on primary urethral carcinoma","url":"https://doi.org/10.1016/j.eururo.2013.03.044"},{"label":"Gakis 2016, World J Urol: international collaboration on primary urethral carcinoma, 154 patients","url":"https://doi.org/10.1007/s00345-015-1583-7"},{"label":"Visser 2012, Eur J Cancer: incidence and survival of rare urogenital cancers in Europe (RARECARE)","url":"https://doi.org/10.1016/j.ejca.2011.10.031"}],"tags":["subtype-page","wave4","rare"],"related":["urethral","urethral-squamous-cell-carcinoma","urethral-adenocarcinoma","urothelial","non-muscle-invasive-bladder-cancer","urethral-melanoma"],"cancers":[],"sections":[],"technologies":[],"targets":["nectin4","fgfr3","pd1"],"drugs":["gemcitabine-cisplatin","cisplatin","enfortumab-vedotin","pembrolizumab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"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"],"standardOfCare":[{"setting":"All stages","approach":"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.","refs":["urethral","urothelial","gemcitabine-cisplatin","enfortumab-vedotin","pembrolizumab"]}],"stateOfArt":[],"history":[],"pipeline":[],"openProblems":[],"parent":"urethral"},"route":"/cancers/urethral-urothelial-carcinoma/","neighbours":{"cancer":[{"id":"urethral-adenocarcinoma","kind":"cancer","name":"Adenocarcinoma of the urethra (including clear cell adenocarcinoma)","route":"/cancers/urethral-adenocarcinoma/"},{"id":"urothelial","kind":"cancer","name":"Bladder & urothelial cancer","route":"/cancers/urothelial/"},{"id":"urethral-melanoma","kind":"cancer","name":"Melanoma of the urethra","route":"/cancers/urethral-melanoma/"},{"id":"non-muscle-invasive-bladder-cancer","kind":"cancer","name":"Non-muscle-invasive bladder cancer","route":"/cancers/non-muscle-invasive-bladder-cancer/"},{"id":"urethral-squamous-cell-carcinoma","kind":"cancer","name":"Squamous cell carcinoma of the urethra","route":"/cancers/urethral-squamous-cell-carcinoma/"},{"id":"urethral","kind":"cancer","name":"Urethral cancer","route":"/cancers/urethral/"}],"target":[{"id":"nectin4","kind":"target","name":"Nectin-4","route":"/targets/nectin4/"},{"id":"pd1","kind":"target","name":"PD-1","route":"/targets/pd1/"}],"term":[{"id":"fgfr3","kind":"term","name":"FGFR3 alterations (bladder cancer)","route":"/terms/fgfr3/"}],"drug":[{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"},{"id":"enfortumab-vedotin","kind":"drug","name":"Enfortumab vedotin","route":"/drugs/enfortumab-vedotin/"},{"id":"gemcitabine-cisplatin","kind":"drug","name":"Gemcitabine + cisplatin","route":"/drugs/gemcitabine-cisplatin/"},{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","route":"/drugs/pembrolizumab/"}]}}