Association of Sociodemographic Characteristics With Survival Among Patients With Urachal Cancer in California From 1988 to 2019

Abstract

Urachal cancer is a rare genitourinary malignant neoplasm that arises from the remnant of the embryological structure between the bladder and allantois. 1 It has been considered an extremely aggressive neoplasm, with a median overall survival (OS) ranging between 12 and 24 months among patients with locally advanced and metastatic disease. 2 Surgery is the preferred treatment for localized and regional disease, and chemotherapy and/or immunotherapy are recommended for metastatic disease. 3 We assessed the sociodemographic characteristics of patients with urachal cancer, treatments, and the association of patient characteristics with survival.Discussion | Despite being traditionally described as an aggressive neoplasm, most patients with urachal cancer did not present with metastatic disease at the time of diagnosis, and the median OS was 76 months. A study limitation is the retrospective nature of this epidemiological study.

A remnant never forgotten: the utility of circulating tumor DNA in treatment guidance of urachal cancer

“…In recent demographic studies of patients with urachal cancer, 56.51% were male with a mean age of 57.98 years and were non-Hispanic white. 7 Standard work-up for urachal cancer includes a cystoscopy to identify tumor localization. 8 Imaging evaluation for staging is traditionally performed with PET scans.…”

“…For individuals with localized or in situ diseases, regional diseases, and metastatic diseases, the median OS is approximately 76, 83, and 19 months, respectively. 7 Advanced tumor stage, failure to perform umbilectomy, primary radiation therapy, late symptom presentation, and high tumor grade are all poor prognostic factors. 11 …”

Treatment approaches for urachal cancer: Use of immunotherapy and targeted therapies

“…A retrospective, population-based study by the California Cancer Registry including 315 patients demonstrated that individuals with localized disease lived longer (178 months) than those with locally advanced (83 months) or metastatic disease (19 months), and found no differences in survival based off sex, ethnicity, or neighborhood socioeconomic status. 10 Although there is no standard accepted staging system, the two most commonly used staging systems including the Sheldon staging system (stages I-IV) and Mayo staging system (stages I-IV). 12 Per the Sheldon staging system, stage I disease is defined as cancer confined to the urachal mucosa, stage II disease is defined as invasion confined to the urachus itself, stage III disease (A-D) includes local extension, and stage IV disease is metastatic to lymph nodes (A) or distant sites (B).…”

“… 9 Several population-based studies have demonstrated a higher incidence of urachal cancer in men and during the fifth decade of life. 10 Based off data from the Surveillance, Epidemiology and End Results (SEER) database, the most common histology is adenocarcinoma which represented over 80% of cases, followed by less frequent histologies such as squamous cell carcinoma and sarcoma. 11 The same cohort of 420 patients found that nearly 60% of patients presented with locally advanced or metastatic disease (stage III and stage IV disease, respectively) per American Joint Committee on Cancer (AJCC) staging.…”

“…A retrospective, population-based study by the California Cancer Registry including 315 patients demonstrated that individuals with localized disease lived longer (178 months) than those with locally advanced (83 months) or metastatic disease (19 months), and found no differences in survival based off sex, ethnicity, or neighborhood socioeconomic status. 10 …”