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Extended Partial Cystectomy vs Radical Cystectomy for Urachal Carcinoma
In a study exploring treatment options for patients with urachal carcinoma, partial cystectomy and radical cystectomy were found to have similar oncologic results, with postoperative adjuvant chemotherapy significantly reducing the risk of recurrence.
Study authors wrote urachal carcinoma has “an insidious onset, high risk of recurrence, and a poor prognosis.” They added surgical resection on its own does not often result in complete disease control. This study aimed to compare treatment options and identify prognostic risk factors for this patient population.
This retrospective analysis included 163 patients with urachal carcinoma across 6 medical centers. Clinical data, treatment and follow-up results were accessed to assess the treatment options and prognostic risk factors.
There was no difference in the 5-year recurrence-free survival rate (P = .282) or the overall survival rate (P = .673) between extended partial cystectomy and radical cystectomy for those patients at stage ≤3. There was a significant reduction of recurrence rate with the use of postoperative adjuvant chemotherapy, for patients with stage ≤3b (P = .005). Additionally, those patients who received combination postoperative adjuvant therapy, compared with single chemotherapy or conservative treatment, had better survival time.
There was no significant correlation found between whether a patient underwent a bilateral pelvic lymph node dissection and either the patient’s recurrence (P = .921) or prognosis (P = .741). Multivariate analysis determined that both Sheldon stage and carbohydrate antigen 72-4 >6.02 U/mL were independent risk factors for recurrence.
Source:
Ke C, Xu L, Wang M, et al. Treatment options and prognostic risk factors for urachal carcinoma: A multicenter retrospective study. Urol Oncol. Published October 23, 2022. doi:10.1016/j.urolonc.2022.09.017
