Urachal Carcinoma: Contemporary Surgical Outcomes

Abstract

Wide resection of the tumor mass and entire urachus resulting in negative soft tissue and bladder margins cures the majority of nonmetastatic urachal cancers.

Bladder Cancer in 2010: How Far have We Come?

“…23 Urachal carcinoma is rare, accounting for less than 1% of bladder neoplasms. 74 The urachus is a vestigial structure that connects the bladder to the allantois during early embryonic development and, after birth, becomes the median umbilical ligament. 75 It has intramucosal, intramuscular, and supravesical segments, and urachal neoplasms can arise from any of these areas and can be epithelial or mesenchymal.…”

“…75 Most urachal neoplasms are adenocarcinomas originating from the epithelium of the urachal remnant, but other histological subtypes have been described. 74,76 Treatment for urachal carcinoma is primarily surgical, with extended partial cystectomy, en bloc resection of urachal mass, urachal tract, and umbilicus, and pelvic lymph node dissection; radical cystectomy can be reserved for larger tumors. 74 Radiation and chemotherapy are ineffective.…”

“…74,76 Treatment for urachal carcinoma is primarily surgical, with extended partial cystectomy, en bloc resection of urachal mass, urachal tract, and umbilicus, and pelvic lymph node dissection; radical cystectomy can be reserved for larger tumors. 74 Radiation and chemotherapy are ineffective. 74 Herr et al reported an 88% 5-year survival rate in patients with tumor confined to the urachus, bladder, and periurachal fat compared with a 0% 5-year survival time in patients with tumors that invaded the peritoneal cavity.…”

“…74 Radiation and chemotherapy are ineffective. 74 Herr et al reported an 88% 5-year survival rate in patients with tumor confined to the urachus, bladder, and periurachal fat compared with a 0% 5-year survival time in patients with tumors that invaded the peritoneal cavity. 74 Small cell carcinoma of the urothelial tract is uncommon, representing 0.5%-0.7% of all urothelial tumors.…”

“…74 Herr et al reported an 88% 5-year survival rate in patients with tumor confined to the urachus, bladder, and periurachal fat compared with a 0% 5-year survival time in patients with tumors that invaded the peritoneal cavity. 74 Small cell carcinoma of the urothelial tract is uncommon, representing 0.5%-0.7% of all urothelial tumors. 77,78 Like its neuroendocrine counterparts in the lung, small cell tumors of the bladder have a rapid growth rate but are chemosensitive.…”