Dr Garje on Clinical Outcomes With Multimodal Approaches in Invasive Primary Urethral Cancer

“Patients with these cancers have an aggressive disease with limited treatment options. When they are diagnosed, it’s always important to have multidisciplinary collaboration between medical oncology, radiation oncology, and surgeons to come up with the best treatment approach for these patients.”

Rohan Garje, MD, chief, Genitourinary Medical Oncology, Baptist Health Miami Cancer Institute, discusses findings from a real-world study that evaluated clinical outcomes among patients with invasive primary urethral cancer (PUC) of varying histologies who received various treatment approaches. 

Garje and colleagues conducted a real-world, multi-institutional study to examine treatment patterns and clinical outcomes for patients with PUC, a rare and aggressive malignancy without an established treatment approach. Due to the absence of prospective studies in this patient population, the optimal management strategy for PUC remains unclear, according to Garje. This study sought to address this gap by analyzing different treatment modalities and their associated outcomes, he says.

Findings presented during the 2025 Genitourinary Cancers Symposium demonstrated significant variability in treatment approaches, with patients receiving surgery alone; radiation alone; neoadjuvant chemotherapy followed by surgery; or a more intensive multimodal regimen combining chemotherapy, radiation, and surgery, Garje details. Despite this treatment heterogeneity, findings indicated that patients who received multimodal therapy had improved disease-free survival compared with those treated with a single modality, he reports. Importantly, no differences in outcomes were observed based on sex or histology, Garje notes.

These findings underscore the necessity of a multidisciplinary approach to optimize treatment outcomes in patients with PUC, Garje says. Given the aggressive nature of the disease and the lack of standardized treatment guidelines, close collaboration between medical oncologists, radiation oncologists, and surgeons is essential to develop individualized treatment strategies, he emphasizes. Future research should focus on prospective studies to refine treatment recommendations and establish evidence-based guidelines for managing this rare malignancy, he concludes.