MP56-03 CLINICAL OUTCOMES AND SURGICAL MANAGEMENT OF URACHAL CARCINOMA: AN ANALYSIS OF THE NATIONAL CANCER DATABASE

Abstract

You have accessJournal of UrologyCME1 May 2022MP56-03 CLINICAL OUTCOMES AND SURGICAL MANAGEMENT OF URACHAL CARCINOMA: AN ANALYSIS OF THE NATIONAL CANCER DATABASE Furkan Dursun, Kelvin Lim, Evan Wenker, Jiaqiong Xu, Robert Svatek, Ahmed Mansor, Zachary Klaassen, Taliah Muhammed, Ziad El-Zaatari, Steven Shen, Eleni Efstathiou, Guru Sonpavade, Christopher Wallis, and Raj Satkunasivam Furkan DursunFurkan Dursun More articles by this author , Kelvin LimKelvin Lim More articles by this author , Evan WenkerEvan Wenker More articles by this author , Jiaqiong XuJiaqiong Xu More articles by this author , Robert SvatekRobert Svatek More articles by this author , Ahmed MansorAhmed Mansor More articles by this author , Zachary KlaassenZachary Klaassen More articles by this author , Taliah MuhammedTaliah Muhammed More articles by this author , Ziad El-ZaatariZiad El-Zaatari More articles by this author , Steven ShenSteven Shen More articles by this author , Eleni EfstathiouEleni Efstathiou More articles by this author , Guru SonpavadeGuru Sonpavade More articles by this author , Christopher WallisChristopher Wallis More articles by this author , and Raj SatkunasivamRaj Satkunasivam More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002639.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Carcinoma of the urachus is a rare disease, which accounts for less than 1% of all bladder cancers with an estimated annual incidence of 1 in 5 million individuals. Given the rarity of urachal cancer, contemporary diagnostic and treatment evidence are mostly derived from single-institution case series. Contemporary population-based data remains limited. Therefore, we aimed to define the patient characteristics, clinicopathological features, and survival outcomes of patients diagnosed with urachal carcinoma. METHODS: The National Cancer Database from 2006 to 2016 was used to identify patients diagnosed with urachal carcinoma. Patients were stratified by staging subgroups and receipt of partial or radical cystectomy. Kaplan Meier analyses determined median and 5-year overall survival (OS) rates and univariable and multivariable analyses were conducted to identify clinical and pathologic characteristics associated with OS duration. Subgroup analyses were conducted to evaluate the association between systemic therapy and survival for metastatic disease. RESULTS: A total of 841 patients with urachal carcinoma were identified. The most common histologic subtypes were non-mucinous adenocarcinoma (39.6%), and mucinous adenocarcinoma (39.1%). Approximately half of the patients had ≥cT2 disease, and 14.3% (n=114) had metastasis at diagnosis. The most common surgical management was partial cystectomy (PC) 60% (n=508). Regional lymph node dissection was performed for 377 patients (44.8%), of which 73 patients (19.4%) had nodal involvement. The median OS was 59 months, and 5-year survival rate was 49%. Among patients with localized disease, we found no significant difference in survival between those treated with partial and radical cystectomy (HR 1.75, 95% CI 0.72-4.3). Further, among those with metastatic disease, receipt of systemic therapy was not associated with prolonged survival benefit (HR=0.79, 95% CI 0.37-1.65). CONCLUSIONS: Urachal carcinoma is rare, high-risk cancer with predominant histologic types of either non-mucinous adenocarcinoma or mucinous adenocarcinoma. These observational data, while limited due to confounding by indication and selection biases, do not demonstrate significant associations between particular treatment approaches and survival. Further prospective research is needed to improve patient outcomes and develop standardized treatment approaches for this rare malignancy. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e971 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Furkan Dursun More articles by this author Kelvin Lim More articles by this author Evan Wenker More articles by this author Jiaqiong Xu More articles by this author Robert Svatek More articles by this author Ahmed Mansor More articles by this author Zachary Klaassen More articles by this author Taliah Muhammed More articles by this author Ziad El-Zaatari More articles by this author Steven Shen More articles by this author Eleni Efstathiou More articles by this author Guru Sonpavade More articles by this author Christopher Wallis More articles by this author Raj Satkunasivam More articles by this author Expand All Advertisement PDF DownloadLoading ...