EAU Guidelines on Primary Urethral Carcinoma

EUROPEAN UROLOGY 64 (2013) 823–830

available at www.sciencedirect.com journal homepage: www.europeanurology.com

Guidelines

EAU Guidelines on Primary Urethral Carcinoma Georgios Gakis a,*, J. Alfred Witjes b, Eva Compe´rat c, Nigel C. Cowan d, Maria De Santis e, Thierry Lebret f, Maria J. Ribal g, Amir M. Sherif h a

Department of Urology, Eberhard-Karls University, Tu¨bingen, Germany; b Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen,

The Netherlands;

c

Department of Pathology, Groupe Hospitalier Pitie´ – Salpeˆtrie`re, Paris, France;

d

Imaging Department, Queen Elizabeth Hospital

Birmingham, Edgbaston, Birmingham, United Kingdom; e 3rd Medical Department and ACR-ITR/CEADDP and LBI-ACR Vienna-CTO, Kaiser Franz Josef Spital, Vienna, Austria; f Department of Urology, Foch Hospital, Suresnes, France; g Department of Urology, Hospital Clinic, University of Barcelona, Barcelona, Spain; h

Department of Surgical and Perioperative Science, Umea˚ University, Umea˚, Sweden

Article info

Abstract

Article history: Accepted March 23, 2013 Published online ahead of print on April 2, 2013

Context: The European Association of Urology (EAU) Guidelines Group on MuscleInvasive and Metastatic Bladder Cancer prepared these guidelines to deliver current evidence-based information on the diagnosis and treatment of patients with primary urethral carcinoma (UC). Objective: To review the current literature on the diagnosis and treatment of patients with primary UC and assess its level of scientific evidence. Evidence acquisition: A systematic literature search was performed to identify studies reporting urethral malignancies. Medline was searched using the controlled vocabulary of the Medical Subject Headings database, along with a free-text protocol. Evidence synthesis: Primary UC is considered a rare cancer, accounting for 10 yr) were considered if they contained historically relevant data or in the absence of newer data. 3.

Level of evidence and grade of recommendation

References in the text were assessed according to their level of evidence (LE), and a grade of recommendation (GR) was assigned according to the lists in Tables 1 and 2, based on the Oxford Centre for Evidence-based Medicine levels of evidence [3]. Grading aims to provide transparency between the underlying evidence and the recommendation given [3]. Because primary UC belongs to the family of rare cancers, most studies are retrospective, and recommendations given in these guidelines are mainly based on level 3 evidence. 4.

Epidemiology

Primary UC is considered a rare cancer, accounting for