An Expert Explains The Risk and Outcomes of Primary Urothelial Cancer Treatment

Primary urothelial cancer has variable histologies, making its treatment complex, leading to varied treatment outcomes with high rates of recurrence in patients, according to data from a retrospective study which was presented in a poster at the 2025 ASCO Genitourinary Cancers Symposium.

The investigation analyzed clinical outcomes in 82 patients across 10 international cancer centers; the most common histologies were urothelial carcinoma (40%), squamous carcinoma (32%) and adenocarcinoma (12%) and patients were diagnosed with stage 2 (30%), 3 (26%) or 4 (44%) disease. Treatment approaches varied, with 51% undergoing surgery alone, 19% receiving neoadjuvant chemotherapy followed by surgery and 11% undergoing concurrent chemoradiation followed by surgery. Furthermore, the overall disease-free survival rate was 54% after a median follow-up of 15.5 months, with 43% experiencing disease recurrence.

In an interview with CURE®, Dr. Rohan Garje, lead author of the study, delved deeper into these outcomes, discussing what the biggest challenges in treating invasive primary urethral cancer are, and how patients can best work with their healthcare team to improve their chances of a successful outcome. Garje is a medical oncologist and the chief of genitourinary medical oncology at Miami Cancer Institute in Florida.

Transcript:

The biggest thing I would say for patients is [to understand] that this is a rare cancer, so try to get an opinion from centers which are tertiary cancer centers. This is because that gives them access to potential clinical trials and also requests for multidisciplinary care. I believe that that is key.

One important thing is that there are some risk factors for primary urethral cancer, including patients with history of urethral strictures, sexually transmitted disease or urethral trauma. In females [this increased risk] comes from birth related injuries to their urethra, making them high-risk for this cancer. Keeping an eye on those symptoms, having a routine follow-up with their primary care physician or urologist [is vital]. I know it's a rare, rare cancer, but [do not] ignore symptoms. Once a workup has been done, if there is some concern for cancer, seeking care at a tertiary treatment center or a multidisciplinary approach is key for better outcomes.

Transcript has been edited for clarity and conciseness.

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