Abstract
BackgroundMalignant urachal tumor is a rare subtype of genitourinary cancer. Our aim was to explore the optimal chemotherapy regimens for relapsed or metastatic urachal carcinoma.Materials and MethodsWe retrospectively enrolled 24 adult patients with relapsed or metastatic urachal carcinoma from January 2014 to September 2020 at Sun Yat-sen University Cancer Center. We summarized the chemotherapy regimens and classified them as fluorouracil based, platinum based, and paclitaxel based. Nine patients received XELOX (capecitabine and oxaliplatin) regimens, seven patients received TX (paclitaxel and capecitabine) regimens, and eight of them received chemotherapy including GP (gemcitabine and cisplatin), TP (paclitaxel and cisplatin), TN (paclitaxel and nedaplatin), and tislelizumab.ResultsThe disease control rate was 75%. Among all patients, one patient treated with XELOX achieved partial remission (PR), while 17 patients showed stable disease. The median progression-free survival (PFS) and overall survival (OS) in all treated patients was 7.43 and 29.7 months, respectively. The patients receiving first-line platinum-based chemotherapy presented better PFS than those without platinum (median PFS 8.23 vs. 3.80 months, p = 0.032), but not significant for OS between two groups. There is no significant difference in PFS and OS for fluorouracil-based and paclitaxel-based groups as first-line regimen. Next-generation gene sequencing revealed TP53 mutation and low tumor mutational burden in five out of seven cases.ConclusionThe platinum-based chemotherapy regimen is effective for relapsed or metastatic urachal carcinoma.
Highlights
Malignant urachal tumor (MUT) is a rare genitourinary tumor derived from the urachus at the dome of the bladder, accounting for 0.1%–0.7% of all malignant bladder cancers [1]
One patient treated with XELOX achieved partial remission (PR), while 17 patients showed stable disease
There is no significant difference in progression-free survival (PFS) and overall survival (OS) for fluorouracil-based and paclitaxel-based groups as first-line regimen
Summary
Malignant urachal tumor (MUT) is a rare genitourinary tumor derived from the urachus at the dome of the bladder, accounting for 0.1%–0.7% of all malignant bladder cancers [1]. Literatures about MUT are mainly based on some of case reports and few retrospective studies [3,4,5,6]. MUT resembles enteric adenocarcinoma histologically and may respond to chemotherapy used to treat colorectal cancer [13]. Most of MUT cases expressed CDX2 and CK20 [9, 13, 14], which was positive in adenocarcinoma of colorectal cancer. The chemotherapy regimens are similar to those for colorectal cancer, but the efficacy varies in different reports [4, 18,19,20]. We present the results of a retrospective study of treatment outcome in different chemotherapy regimens in patients with advanced or relapsed MUT in Sun Yat-sen Cancer Center (SYSUCC). Our aim was to explore the optimal chemotherapy regimens for relapsed or metastatic urachal carcinoma
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