{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T20:51:21Z","timestamp":1768423881116,"version":"3.49.0"},"reference-count":26,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Objective: To evaluate treatment patterns, predictors of treatment selection, and overall survival (OS) in patients with noninvasive (Ta\u2013Tis) urothelial carcinoma of the urethra (UUC). Patients and Methods: We conducted a retrospective cohort study of adults diagnosed with noninvasive UUC (stage Ta or Tis, N0, M0) between 2018 and 2021 using the National Cancer Database. Patients were categorized into prostatic and non-prostatic urethral cohorts. Treatment groups included endoluminal ablation alone, ablation combined with topical intraluminal therapy, urethrectomy, and no subsequent treatment. Multinomial logistic regression was used to identify predictors of treatment selection. The OS was assessed using Kaplan\u2013Meier and multivariable Cox regression, with separate models for each anatomical cohort. Results: A total of 436 patients were included (185 non-prostatic, 251 prostatic); 91.9% (n = 401) were male. Ablation alone was the most common treatment in both cohorts (non-prostatic: 57.3%; prostatic: 62.6%), followed by urethrectomy (non-prostatic: 21.1%) and ablation plus topical therapy (prostatic: 20.3%). In the non-prostatic cohort, high-grade histology (OR 15.15; 95% CI, 3.82\u201360.04) and Tis stage (OR 3.27; 95% CI, 1.10\u20139.69) were associated with increased odds of urethrectomy. In the prostatic cohort, high-grade histology was associated with increased use of urethrectomy (OR 59.29; 95% CI, 4.61\u2013763.17) and ablation plus topical therapy (OR 3.09; 95% CI, 1.21\u20137.90). Tis stage was also associated with ablation plus topical therapy (OR 2.53; 95% CI, 1.14\u20135.62). This treatment approach was associated with improved OS compared with ablation alone (HR 0.18; 95% CI, 0.05\u20130.60; p = 0.005). Conclusions: Treatment selection differed substantially by tumor location, stage, and grade, reflecting both treatment selection in noninvasive UUC varied by tumor location, grade, and stage. In prostatic tumors, ablation plus topical therapy was associated with improved survival, supporting its role as a risk-adapted, organ-sparing strategy in selected patients.<\/jats:p>","DOI":"10.3390\/curroncol33010045","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T11:01:14Z","timestamp":1768388474000},"page":"45","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-World Treatment Patterns and Outcomes of Intraluminal Ablative Therapies in Noninvasive Urethral Carcinoma: A National Cancer Database Analysis"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9578-3666","authenticated-orcid":false,"given":"Eusebio","family":"Luna Velasquez","sequence":"first","affiliation":[{"name":"Department of Urology, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vatsala","family":"Mundra","sequence":"additional","affiliation":[{"name":"Department of Urology, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renil S.","family":"Titus","sequence":"additional","affiliation":[{"name":"Department of Urology, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3463-2327","authenticated-orcid":false,"given":"Jiaqiong","family":"Xu","sequence":"additional","affiliation":[{"name":"Center for Health Data Science and Analytics, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Riveros","sequence":"additional","affiliation":[{"name":"Department of Urology, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1942-2743","authenticated-orcid":false,"given":"Dharam","family":"Kaushik","sequence":"additional","affiliation":[{"name":"Department of Urology, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amar","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Urology, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suran","family":"Somawardana","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, Rice University, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5990-4026","authenticated-orcid":false,"given":"Christopher J. D.","family":"Wallis","sequence":"additional","affiliation":[{"name":"Division of Urology and Surgical Oncology, Department of Surgery, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5S 1A1, Canada"},{"name":"Division of Urology, University of Toronto, Toronto, ON M5S 1A1, Canada"},{"name":"Division of Urology, Mount Sinai Hospital, Toronto, ON M5T 3L9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raj","family":"Satkunasivam","sequence":"additional","affiliation":[{"name":"Department of Urology, Houston Methodist Hospital, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1016\/j.urology.2006.08.1057","article-title":"Incidence of Primary Urethral Carcinoma in the United States","volume":"68","author":"Swartz","year":"2006","journal-title":"Urology"},{"key":"ref_2","first-page":"627","article-title":"Incidence Rates and Contemporary Trends in Primary Urethral Cancer","volume":"32","author":"Wenzel","year":"2021","journal-title":"Cancer Causes Control"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.ejca.2011.10.031","article-title":"Incidence and Survival of Rare Urogenital Cancers in Europe","volume":"48","author":"Visser","year":"2012","journal-title":"Eur. J. Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/bju.12630","article-title":"Management of Advanced Primary Urethral Carcinomas","volume":"114","author":"Dayyani","year":"2014","journal-title":"BJU Int."},{"key":"ref_5","unstructured":"National Comprehensive Cancer Network (2023). NCCN Clinical Practice Guidelines in Oncology: Bladder Cancer (Version 2.2023), NCCN. Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/bladder.pdf."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/j.euo.2020.06.003","article-title":"European Association of Urology Guidelines on Primary Urethral Carcinoma-2020 Update","volume":"3","author":"Gakis","year":"2020","journal-title":"Eur. Urol. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"10.e7","DOI":"10.1016\/j.urolonc.2017.09.012","article-title":"The Prognostic Effect of Salvage Surgery and Radiotherapy in Patients with Recurrent Primary Urethral Carcinoma","volume":"36","author":"Gakis","year":"2018","journal-title":"Urol. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1097\/COC.0000000000000391","article-title":"Treatment and Outcomes of Primary Urethra Cancer","volume":"41","author":"Eng","year":"2018","journal-title":"Am. J. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1111\/j.1442-2042.2006.01392.x","article-title":"Clinical Outcome of 36 Male Patients With Primary Urethral Carcinoma: A Single Center Experience","volume":"13","author":"Thyavihally","year":"2006","journal-title":"Int. J. Urol."},{"key":"ref_10","unstructured":"American College of Surgeons, Commission on Cancer (2025). National Cancer Database, American College of Surgeons. Available online: https:\/\/www.facs.org\/quality-programs\/cancer\/ncdb\/."},{"key":"ref_11","unstructured":"(2021). Stata Statistical Software: Release 17, StataCorp LLC."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/j.eururo.2005.12.019","article-title":"Intravesical Instillations With Bacillus Calmette-Gu\u00e9rin for the Treatment of Carcinoma in Situ Involving Prostatic Ducts","volume":"49","author":"Schatteman","year":"2006","journal-title":"Eur. Urol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"521.e1","DOI":"10.1016\/j.urolonc.2025.04.007","article-title":"Bladder-Sparing Management for High Grade Noninvasive Urothelial Carcinoma of the Prostate","volume":"43","author":"Martin","year":"2025","journal-title":"Urol. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.ucl.2010.04.011","article-title":"Surgery for Urethral Cancer","volume":"37","author":"Karnes","year":"2010","journal-title":"Urol. Clin. N. Am."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1016\/S0090-4295(98)00659-1","article-title":"Male Urethral Carcinoma: Analysis of Treatment Outcome","volume":"53","author":"Dalbagni","year":"1999","journal-title":"Urology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.urology.2006.05.059","article-title":"Urothelial Carcinoma of the Prostate","volume":"69","author":"Palou","year":"2007","journal-title":"Urology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1111\/j.1464-410X.2008.08210.x","article-title":"Prostatic Urothelial Carcinoma: Is Transurethral Prostatectomy Necessary Before Bacillus Calmette-Gu\u00e9rin Immunotherapy?","volume":"103","author":"Gofrit","year":"2009","journal-title":"BJU Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"386","DOI":"10.3816\/CGC.2007.n.021","article-title":"Long-Term Follow-Up of Intravesical Bacillus Calmette-Gu\u00e9rin Treatment for Superficial Transitional-Cell Carcinoma of the Bladder Involving the Prostatic Urethra","volume":"5","author":"Taylor","year":"2007","journal-title":"Clin. Genitourin. Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1002\/cam4.4917","article-title":"Racial Inequity and Other Social Disparities in the Diagnosis and Management of Bladder Cancer","volume":"12","author":"Hasan","year":"2023","journal-title":"Cancer Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/S1470-2045(17)30445-X","article-title":"Burden and Centralised Treatment in Europe of Rare Tumours: Results of RARECAREnet\u2014A Population-Based Study","volume":"18","author":"Gatta","year":"2017","journal-title":"Lancet Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"133.e17","DOI":"10.1016\/j.urolonc.2020.09.020","article-title":"The Effect of Centralization of Care on Overall Survival in Primary Urethral Cancer","volume":"39","author":"Stone","year":"2021","journal-title":"Urol. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"161.e17","DOI":"10.1016\/j.urolonc.2024.01.022","article-title":"Unmarried Status Effect on Stage at Presentation and Treatment Patterns in Primary Urethral Carcinoma Patients","volume":"42","author":"Morra","year":"2024","journal-title":"Urol. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.urology.2016.09.042","article-title":"Outcomes and Prognostic Factors of Primary Urethral Cancer","volume":"100","author":"Sui","year":"2017","journal-title":"Urology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.urology.2012.02.058","article-title":"Prognostic Factors and Outcomes After Definitive Treatment of Female Urethral Cancer: A Population-Based Analysis","volume":"80","author":"Champ","year":"2012","journal-title":"Urology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"369.e9","DOI":"10.1016\/j.urolonc.2020.11.031","article-title":"The Effect of Race\/Ethnicity on Histological Subtype Distribution, Stage at Presentation and Cancer Specific Survival in Urethral Cancer","volume":"39","author":"Wenzel","year":"2021","journal-title":"Urol. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.clgc.2020.12.001","article-title":"Sex-Related Differences Include Stage, Histology, and Survival in Urethral Cancer Patients","volume":"19","author":"Wenzel","year":"2021","journal-title":"Clin. Genitourin. Cancer"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/1\/45\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T11:42:08Z","timestamp":1768390928000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/1\/45"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,14]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["curroncol33010045"],"URL":"https:\/\/doi.org\/10.3390\/curroncol33010045","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,14]]}}}