Urachal carcinoma: Impact of recurrence pattern and lymphadenectomy on long‐term outcomes

Abstract

Background Urachal carcinoma is a rare nonurothelial malignant tumor with high rates of local recurrence and systemic metastasis. Although radical resection is widely considered the standard treatment, there is still a debate regarding the benefits of lymphadenectomy. To explore these factors, we investigated the recurrence pattern of urachal cancer and the impact of lymphadenectomy on long‐term survival. Methods The data of 62 patients pathologically diagnosed with urachal carcinoma at Sun Yat‐sen University Cancer Center from 2002 to 2019 were retrospectively reviewed. Lymphadenectomy was defined as lymph nodes retrieved from the obturator, internal iliac, and external iliac lymph node stations. The Kaplan‐Meier method and Cox regression model were used to identify prognostic factors. OS and DFS were the primary endpoints. Results Of the 47 males and 15 females included, 54 patients underwent partial cystectomy, and 27 patients underwent lymphadenectomy. The number of patients with Sheldon stage IIIA, IIIB, IIIC, IVA, and IVB were 43 (69.4%), 4 (6.5%) 3 (4.8%), 6 (9.7%), and 6 (9.7%), respectively. The median DFS was 32.7 months, and the mean OS was 114.6 months. Sheldon stage (P < .001) and tumor size (P = .001) were identified as independent prognostic factors for DFS, whereas Sheldon stage (P = .003), peritoneal metastasis (P = .006), distant metastasis (P = .024), and recurrence in pelvic lymph nodes (P = .015) were independent prognostic factors for OS. Conclusions Urachal carcinoma has a high recurrence rate, but only peritoneal metastasis, distant metastasis, and recurrence in pelvic lymph nodes were found to be associated with OS. Lymphadenectomy was recommended because of its role in accurately staging the disease, and further research is needed to focus on lymphadenectomy and standardized the procedure.

The Prognosis and Oncological Predictor of Urachal Carcinoma of the Bladder: A Large Scale Multicenter Cohort Study Analyzed 203 Patients With Long Term Follow-Up

“…The mean values of OS, CSS, and RFS in this study are similar to previous studies ( 24 ). However, 5- and 10-year survival rates are relatively higher than previous studies ( 10 , 14 , 25 ).…”

Urachal Carcinoma: Are Lymphadenectomy and Umbilectomy Necessary?

“…Thus, lymphadenectomy might be beneficial [ 8 ]. Lymphadenectomy might be helpful in staging tumors, predicting prognosis, and guiding further treatment [ 20 ]. In this study, surgery with umbilectomy was an important prognostic factor for OS and PFS.…”

Clinical and Radiological Features of Urachal Carcinoma and Infection

“…Both tumors and infections are common complications of adult urachal abnormalities. Urachal carcinoma is a rare and highly malignant tumor with low morbidity, accounting for only 0.01% of all cancers and 0.34% of all bladder neoplasms annually, and it mainly occurs in men (7)(8)(9)(10). Most urachal cancers are adenocarcinomas, including mucinous gland type, intestinal type, mixed type, signet ring cell type, and so on (11,12).…”