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Population based survival data on urachal tumors.

Jehonathan H Pinthus1, Riad Haddad, John Trachtenberg

  • 1Department of Surgical Oncology (Division of Urology), University Health Network, University of Toronto, Toronto, Ontario, Canada.

The Journal of Urology
|May 16, 2006
PubMed
Summary

Urachal adenocarcinoma, a rare bladder cancer, can achieve long-term survival with partial cystectomy. Well-differentiated tumors and no organ involvement predict better outcomes in urachal cancer patients.

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Area of Science:

  • Urology
  • Oncology
  • Cancer Research

Background:

  • Urachal carcinoma is a rare malignancy, representing less than 1% of all bladder cancers.
  • Existing data on urachal carcinoma outcomes are limited, primarily derived from case reports and specialized centers.
  • Population-based analyses with long-term follow-up are crucial for understanding disease-related outcomes.

Purpose of the Study:

  • To conduct a population-based outcomes analysis of urachal carcinoma patients in Ontario.
  • To evaluate long-term disease-specific survival and overall survival.
  • To identify predictors of outcome, including patient age, sex, tumor grade, stage, and treatment hospital type.

Main Methods:

  • A cohort of 40 patients diagnosed with urachal adenocarcinoma between 1976 and 2001 was identified from the Ontario Cancer Registry.

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  • Primary outcome measures included overall survival and disease-specific survival.
  • Statistical analysis assessed the impact of patient demographics, tumor characteristics, and treatment setting on survival.

    • Main Results:

    • Median patient age was 52 years, with a median follow-up of 72.7 months.
    • Mean overall survival was 121.6 months; mean disease-specific survival for operatively treated patients was 165 months.
    • Five-year and 10-year disease-specific survival rates were 61.3% and 49.2%, respectively. Well-differentiated tumors (90% cure rate with operative treatment), absence of adjacent organ involvement, and lack of peritoneal involvement correlated with better prognosis (p=0.004, p=0.03, p=0.045).

    Conclusions:

    • Urachal adenocarcinoma affects all age groups, and long-term disease-specific survival is achievable with partial cystectomy.
    • Favorable prognostic factors include well-differentiated tumor grade and the absence of adjacent organ or peritoneal spread.
    • No disease relapses were observed beyond 7 years post-diagnosis, suggesting a potential plateau in mortality.