Urachal Carcinoma: Insights From a National Database

Area of Science:

• Urology
• Oncology
• Cancer Research

Background:

• Urachal carcinoma (UrC) is a rare, nonurothelial bladder cancer, accounting for <1% of all bladder cancers.
• Typically diagnosed in men aged 50-60, often at advanced or metastatic stages.
• This study investigates UrC patient demographics, clinical characteristics, and management strategies.

Purpose of the Study:

• To examine the population characteristics of urachal carcinoma (UrC) patients.
• To analyze the management and treatment trends for UrC.
• To identify factors influencing surgical approach in UrC.

Main Methods:

• Utilized the PearlDiver Mariner database (2010-2022) to identify UrC patients from bladder biopsies or TURB.
• Descriptive statistics were employed for patient characteristics.
• Student's T-Tests and Fisher's exact tests were used to compare patient groups and assess significance (P < .05).

Main Results:

• Analyzed 2475 UrC patients (mean age 69.2 years, 73.1% male); 16.2% had social determinants of health (SDOH) factors.
• Smoking (54.5%), diabetes (42.9%), and obesity (25.2%) were common comorbidities.
• A trend towards partial cystectomy (60.55 ± 12.92 years) over radical cystectomy (66.74 ± 8.13 years) was observed for localized UrC, with higher SDOH prevalence in the partial cystectomy group (P = .03).

Conclusions:

• Urachal carcinoma (UrC) predominantly affects older men and is frequently diagnosed at advanced stages.
• A shift towards partial cystectomy for localized UrC is suggested by the data.
• Further research is warranted for personalized surgical approaches and multidisciplinary care to improve UrC outcomes.