Clinical outcomes and patterns of population-based management of urachal carcinoma of the bladder: An analysis of the National Cancer Database.
partial cystectomy
perioperative chemotherapy
radical cystectomy
survival outcome
urachal carcinoma
Journal
Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
revised:
24
02
2022
received:
28
01
2022
accepted:
08
04
2022
pubmed:
6
5
2022
medline:
24
11
2022
entrez:
5
5
2022
Statut:
ppublish
Résumé
Given the low incidence of urachal carcinoma of the bladder (UCB), there is limited published data from contemporary population-based cohorts. This study aimed to describe demographic, clinicopathological features, and survival outcomes of patients diagnosed with UCB. The National Cancer Database (2004-2016) was queried for UCB patients. Descriptive analyses characterized demographics and clinicopathologic features. We assessed 5-year overall survival (OS) rates of the entire cohort and subgroups of localized/locally advanced and metastatic disease. We utilized Cox proportional hazards models to assess the association between covariates of interest and all-cause mortality and to examine the impact of surgical technique and chemotherapy. We identified 841 patients with UCB. The most common histologic subtype was non-mucinous adenocarcinoma (39.6%). Approximately 50% had ≥cT2 disease, and 14.3% were metastatic at diagnosis. Altogether, partial cystectomy (60%) was most performed, and lymph node dissection was performed in 377 patients (44.8%), with specific temporal increase in utilization over the study period (p < 0.001). Overall, median OS was 59 months, and 5-year OS was 49%. In patients with localized/locally advanced disease, we found no association between partial and radical cystectomy (Hazards ratio [HR] 1.75; 95% CI 0.72-4.3) as well as receipt of perioperative chemotherapy (HR 1.97, 95% CI 0.79-4.90) and outcomes. Lastly, receipt of systemic therapy was not associated with survival benefit (HR 0.785, 95% CI 0.37-1.65) in metastatic disease cohort. This large population-based cohort provides insight into the surgical management and systemic therapy, without clear evidence on the association of chemotherapy and survival in the perioperative and metastatic setting.
Sections du résumé
BACKGROUND
Given the low incidence of urachal carcinoma of the bladder (UCB), there is limited published data from contemporary population-based cohorts. This study aimed to describe demographic, clinicopathological features, and survival outcomes of patients diagnosed with UCB.
METHODS
The National Cancer Database (2004-2016) was queried for UCB patients. Descriptive analyses characterized demographics and clinicopathologic features. We assessed 5-year overall survival (OS) rates of the entire cohort and subgroups of localized/locally advanced and metastatic disease. We utilized Cox proportional hazards models to assess the association between covariates of interest and all-cause mortality and to examine the impact of surgical technique and chemotherapy.
RESULTS
We identified 841 patients with UCB. The most common histologic subtype was non-mucinous adenocarcinoma (39.6%). Approximately 50% had ≥cT2 disease, and 14.3% were metastatic at diagnosis. Altogether, partial cystectomy (60%) was most performed, and lymph node dissection was performed in 377 patients (44.8%), with specific temporal increase in utilization over the study period (p < 0.001). Overall, median OS was 59 months, and 5-year OS was 49%. In patients with localized/locally advanced disease, we found no association between partial and radical cystectomy (Hazards ratio [HR] 1.75; 95% CI 0.72-4.3) as well as receipt of perioperative chemotherapy (HR 1.97, 95% CI 0.79-4.90) and outcomes. Lastly, receipt of systemic therapy was not associated with survival benefit (HR 0.785, 95% CI 0.37-1.65) in metastatic disease cohort.
CONCLUSION
This large population-based cohort provides insight into the surgical management and systemic therapy, without clear evidence on the association of chemotherapy and survival in the perioperative and metastatic setting.
Identifiants
pubmed: 35509235
doi: 10.1002/cam4.4786
pmc: PMC9678087
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
4273-4282Informations de copyright
© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Références
Cancer. 2006 Aug 15;107(4):721-8
pubmed: 16826584
Hum Pathol. 2015 Dec;46(12):1808-14
pubmed: 26364859
Urol Oncol. 2022 Apr;40(4):165.e9-165.e15
pubmed: 34686429
J Urol. 2012 Oct;188(4):1102-7
pubmed: 22901574
Stat Med. 2007 Oct 30;26(24):4505-19
pubmed: 17348080
Cancer. 2007 Dec 1;110(11):2434-40
pubmed: 17932892
N Engl J Med. 2018 Mar 29;378(13):1177-1188
pubmed: 29590544
Am J Surg Pathol. 2012 Mar;36(3):432-42
pubmed: 22301493
Int J Clin Oncol. 2016 Feb;21(1):133-8
pubmed: 26138265
Urol Int. 2012;88(2):209-14
pubmed: 22143067
Stat Med. 1992 Oct-Nov;11(14-15):1871-9
pubmed: 1480879
J Urol. 2016 Jun;195(6):1690-6
pubmed: 26678957
Ann Surg Oncol. 2008 Mar;15(3):683-90
pubmed: 18183467
Cancer Med. 2022 Nov;11(22):4273-4282
pubmed: 35509235
Cancer. 2006 Aug 15;107(4):712-20
pubmed: 16826585
Dis Markers. 2018 Mar 12;2018:7308168
pubmed: 29721106
Adv Anat Pathol. 2016 Mar;23(2):71-83
pubmed: 26849813
J Urol. 2006 Jun;175(6):2042-7; discussion 2047
pubmed: 16697798
J Urol. 1984 Jan;131(1):1-8
pubmed: 6361280
J Urol. 2003 Apr;169(4):1295-8
pubmed: 12629346
Urol Oncol. 2016 Sep;34(9):388-98
pubmed: 27267737
Can Urol Assoc J. 2020 Mar;14(3):E57-E64
pubmed: 31348743
Urol Oncol. 2017 Jan;35(1):33.e11-33.e19
pubmed: 27592530