ObjectiveTo determine the effectiveness and adverse effects of urethrectomy alone or as part of multimodal therapy (MMT).MethodsA comprehensive search was conducted across MEDLINE (OVID), EMBASE, LILACS and the Cochrane Central Register of Controlled Trials (CENTRAL) databases, from their inception to the present date. The study cohort comprised individuals aged 16 years and older diagnosed with urethral tumours at any stage who underwent either isolated urethrectomy or urethrectomy as an integral component of MMT.ResultsNinety‐two studies comprising 25 480 patients met the inclusion criteria. Surgical outcomes for urethral cancer vary considerably, with 5‐year overall survival (OS) ranging from 10% to 68% based on disease extent, approach, and gender. Radiotherapy (RT) alone provides 5‐year OS of approximately 40%. Combined regimens provide better outcomes compared to single modalities, including reduced recurrence and enhanced survival. However, trimodal therapy showed survival benefits only for urothelial subtypes, indicating the need to tailor management according to cancer type. MMT with neoadjuvant chemotherapy prior to surgery demonstrated the most consistent survival gains.ConclusionsThe management of urethral cancer demands a nuanced, personalised approach, accounting for factors such as tumour location, sex, and tumour stage. MMT combining surgery, chemotherapy and RT has shown the ability to enhance outcomes in advanced disease. More extensive collaborative studies through specialised centres are imperative to advance evidence‐based protocols and refine treatment in order to improve survival.

中文翻译：

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尿道癌：全球罕见泌尿生殖肿瘤学会认可的全面审查

目的确定单独尿道切除术或作为多模式治疗 (MMT) 一部分的有效性和不良反应。方法从 MEDLINE (OVID)、EMBASE、LILACS 和 Cochrane 对照试验中央注册库 (CENTRAL) 数据库开始进行全面检索至今。研究队列由年龄在 16 岁及以上、在任何阶段诊断为尿道肿瘤的个体组成，这些个体接受了孤立性尿道切除术或尿道切除术作为 MMT 的一个组成部分。 结果 92 项研究，包括 25 480 名患者，符合纳入标准。尿道癌的手术结果差异很大，根据疾病程度、治疗方法和性别，5 年总生存 (OS) 范围为 10% 至 68%。单独放疗 (RT) 的 5 年 OS 约为 40%。与单一疗法相比，联合疗法可提供更好的结果，包括减少复发和提高生存率。然而，三模式疗法仅对尿路上皮亚型显示出生存获益，这表明需要根据癌症类型调整治疗方案。手术前 MMT 联合新辅助化疗显示出最一致的生存增益。结论 尿道癌的治疗需要采取细致入微、个性化的方法，考虑肿瘤位置、性别和肿瘤分期等因素。 MMT 结合手术、化疗和放疗已显示出改善晚期疾病预后的能力。通过专门中心进行更广泛的合作研究对于推进循证方案和完善治疗以提高生存率至关重要。