Current Understanding of Urachal Adenocarcinoma and Management Strategy

Claps, Mélanie; Stellato, Marco; Zattarin, Emma; Mennitto, Alessia; Sepe, Pierangela; Guadalupi, Valentina; Mennitto, Roberta; Braud, F.G.M. De; Verzoni, Elena; Procopio, Giuseppe

doi:10.1007/s11912-020-0878-z

Cited by 32 publications

(41 citation statements)

References 61 publications

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“…As urachal adenocarcinoma is pathologically similar to colorectal adenocarcinoma, mFOLFOX-6 (leucovorin, fluorouracil, oxaliplatin) regimens have shown effective therapeutic outcomes in previous studies ( 17 ). Early analysis on the combination regimen of 5-fluorouracil, leucovorin, gemcitabine, and cisplatin also showed promising oncological outcomes with 30–40% of radiographic therapeutic response rates, but long-term outcomes need to be further evaluated ( 19 ). In addition, previous literatures have shown that the most effective chemotherapy regimen might be the combination of 5-fluorouracil and cisplatin, which seems to produce better outcomes in terms of response rate compared with other cisplatin-based regeimens ( 19 , 20 ).…”

Section: Discussionmentioning

confidence: 99%

“…Early analysis on the combination regimen of 5-fluorouracil, leucovorin, gemcitabine, and cisplatin also showed promising oncological outcomes with 30–40% of radiographic therapeutic response rates, but long-term outcomes need to be further evaluated ( 19 ). In addition, previous literatures have shown that the most effective chemotherapy regimen might be the combination of 5-fluorouracil and cisplatin, which seems to produce better outcomes in terms of response rate compared with other cisplatin-based regeimens ( 19 , 20 ). Our study results showed that 12 different chemotherapy regimens were used, and even the most commonly used regimen (cisplatin with 5-fluorouracil) were applied to only 22 patient.…”

Section: Discussionmentioning

confidence: 99%

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The Prognosis and Oncological Predictor of Urachal Carcinoma of the Bladder: A Large Scale Multicenter Cohort Study Analyzed 203 Patients With Long Term Follow-Up

Kim

et al. 2021

Front. Oncol.

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AimThis study evaluated the prognosis and survival predictors for bladder urachal carcinoma (UC), based on large scale multicenter cohort with long term follow-up database.MethodsA total 203 patients with bladder UC treated at 19 hospitals were enrolled. Clinical parameters on carcinoma presentation, diagnosis, and therapeutic methods were reviewed for the primary cancer and for all subsequent recurrences. The stage of UC was stratified by Mayo and Sheldon pathological staging system. Oncological outcomes and the possible clinicopathological parameters associated with survival outcomes were investigated.ResultsThe mean age of the patients was 54.2 years. Among the total of 203 patients, stages I, II, III, and IV (Mayo stage) were 48 (23.8%), 108 (53.5%), 23 (11.4%), and 23 (11.4%), respectively. Gross hematuria and bladder irritation symptoms were the two most common initial symptoms. The mean follow-up period was 65 months, and 5-year overall survival rates (OS), cancer-specific survival rates (CSS), and recurrence-free survival rates (RFS) were 88.3, 83.1, and 63.9%, respectively. For the patients with Mayo stage ≥III, OS, CSS, and RFS were significantly decreased to 38.0, 35.2, and 28.4%, respectively. The higher pathological stage (Mayo stage ≥III, Sheldon stage ≥IIIc), positive surgical margin (PSM), and positive lymphovascular invasion (PLM) were independent predictors of shorter OS, CSS, and RFS.ConclusionThe pathological stage, PSM, and PLM were significantly associated with the survival of UC patients, emphasizing an importance of the complete surgical resection of tumor lesion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Prognosis and Oncological Predictor of Urachal Carcinoma of the Bladder: A Large Scale Multicenter Cohort Study Analyzed 203 Patients With Long Term Follow-Up

Kim

et al. 2021

Front. Oncol.

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“…Surgery, including en bloc excision of the umbilicus, entire urachus, and perivesical soft tissue coupled with partial cystectomy or radical cystectomy, is the primary treatment for urachal cancer [ 14 ]. Partial cystectomy and radical cystectomy provide similar oncological results, and no evidence has shown that radical cystectomy is superior to partial cystectomy [ 7 , 8 , 11 , 15 , 16 ]. However, organ-preserving partial cystectomy provides a higher quality of life and less complications and should therefore be preferred [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Urachal Carcinoma: Are Lymphadenectomy and Umbilectomy Necessary?

Jia

Chang

et al. 2020

Med Sci Monit

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“…The case reported by Sahu et al was also treated with immunosuppressants, but the treatment was discontinued after one cycle due to immune pneumonia (18). By reviewing 76 articles (19), Claps concluded that personalized treatment could be the most suitable option for urachal carcinoma. Immunotherapy may have potential utility for urachal carcinoma, but clinical studies are still needed.…”

Section: Discussionmentioning

confidence: 99%

Metastatic Urachal Carcinoma Treated With Several Different Combined Regimens: A Case Report

et al. 2021

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Urachal carcinoma is a rare bladder malignance. This study presents a case of an elderly patient with urachal carcinoma who was found to have pulmonary metastases 1 year after 5 recurrent resections. The patient was treated with up to 7 different chemotherapy regimens, including a VEGF monoclonal antibody and anti-PD-1 antibody. This is the first report of PD-1 antibody being used in patients with urachus, although the disease progressed after only four cycles of the application. The patient’s disease was controlled by the FOLFIRI combined with the VEGF monoclonal antibody regimen. The most prominent issues at present are the difficulty of obtaining drugs for rare cancers and the lack of late-stage clinical trials to guide therapeutic decisions.

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Current Understanding of Urachal Adenocarcinoma and Management Strategy

Cited by 32 publications

References 61 publications

The Prognosis and Oncological Predictor of Urachal Carcinoma of the Bladder: A Large Scale Multicenter Cohort Study Analyzed 203 Patients With Long Term Follow-Up

The Prognosis and Oncological Predictor of Urachal Carcinoma of the Bladder: A Large Scale Multicenter Cohort Study Analyzed 203 Patients With Long Term Follow-Up

Urachal Carcinoma: Are Lymphadenectomy and Umbilectomy Necessary?

Metastatic Urachal Carcinoma Treated With Several Different Combined Regimens: A Case Report

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