14 female patients (11 black and three white; average age, 58 years) were treated for primary urethral carcinoma. Five patients had radical surgery, six received preoperative radiotherapy (2000 cGy in five fractions) followed by anterior exenteration, and three had definitive radiotherapy (external beam 4000 to 5000 cGy plus 2800 to 3000 cGy interstitial implant). The mean follow-up times were 5.6, 3.9, and 2 years, respectively. In the first two groups, two of 11 patients (18%) are alive and well with no evidence of disease. The rest died of local as well as distant disease. In the third group, two of three patients (67%) are alive and well with no evidence of disease. The third patient died of papillary adenocarcinoma of the uterus 30 months later with no evidence of the primary tumor.
Cancer 6254-57, 1988.
ANCER OF THE FEMALE URETHRA is a rare lesion C accounting for less than 1% of all cancers arising from the female genitourinary tract."* Due to the rarity of these lesions, few institutions have experience managing these patients. Traditionally, management has been primarily with surgical approaches ranging from simple local excision to anterior exenteration with or without preoperative irradiation. More recently, external beam radiation alone, brachytherapy alone using radium or iridium sources, or a combination of the two have been shown to be effective without the patient suffering a functional loss of the bladder.213 Again, the rarity of the disease and changes and improvements in the various treatment techniques have prevented unanimity of opinion as to the selection of proper treatment for indi-vidual~.~ Against the background of the small series of cases and the relatively poor results of treatment reported in the literat~re,"~ it was interesting to review our own experience in the treatment of female urethral carcinoma dating back to 195 1.