Staging of Urethral Cancer

The most commonly used staging system utilizes the TNM classification as indicated in the 2010 AJCC cancer staging handbook (Table 8.3).13

The alternative staging system known as the Whitmore classification is shown in Table 8.4.15

Table 8.4 The Whitmore classification of urethral tumors

Stage 0 Confined to mucosa only (in situ carcinoma)

Stage A Into but not beyond lamina propria

Stage B Into but not beyond the substance of the corpus spongiosum, or into but not beyond the prostate

Stage C Direct extension into tissue beyond the corpus spongiosum (corpus cavernosum, muscle, fat, fascia, skin, direct skeletal involvement), or beyond the prostatic capsule

Stage D 1. Inguinal lymph nodes

2. Pelvic lymph nodes below the bifurcation of the aorta

3. Lymph nodes above the bifurcation of the aorta

4. Distant

Table 8.5 Reported frequency of the presenting symptoms for patients with urethral cancer

Hopkins

Srinivas and

Dinney

Dalbagni

Thyavihally

et al.36

Khan37

et al.5

et al.7

et al.11

n

26

200

21

46

36

Urinary obstruction (%)

38

47

29

43

42

Palpable mass (%)

56

79

25

28

28

Hematuria (%)

60

22

25

17

19

Urethral discharge (%)

60

22

25

11

-

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