Study on Metastatic Urachal Carcinoma

Overall, the very aggressive nature of metastatic urachal carcinoma (m-UraC), when distant metastases are present, and observed that m-UraC patients exposed to chemotherapy exhibited lower overall mortality (OM) and cancer-specific mortality, according to a new study conducted by Rocco Simone Flammia and team (CSM). The findings of this study were published in the Journal of Urologic Oncology.

Urachal carcinoma is a rare non-urothelial cancer that commonly affects the bladder's midline or dome as a result of direct extension from the urachal ligament, which is where the tumour originates. Urachal cancer usually manifests at an advanced stage because tumour development is silent. For localized disease, surgery has been found to be successful, but there is no proven treatment for metastasis. The researchers used the most recent Surveillance, Epidemiology, and End Results (SEER) database to test the hypothesis that chemotherapy may improve survival in m-UraC patients.

m-UraC patients aged 18 years were identified in the SEER database (2004-2016). Overall mortality (OM) and cancer-specific mortality (CRR) were addressed using propensity score matching (PSM: cystectomy status, age, and gender), Kaplan-Meier plots, cumulative incidence plots, Cox regression models, and competing risks regression (CRR) models (CSM).

Findings of the Study

• There were 274 m-UraC patients in total, with a median age of 70 years. The majority (66 percent) were Caucasian men (72%).
• Overall, 32% received chemotherapy. Chemotherapy-exposed patients were younger and had cystectomy more frequently.
• The median OM and CSM in 274 m-UraC patients were 6 (4 -10) months and 8 (6 -14) months, respectively.
• Chemotherapy-exposed patients had lower OM and CSM after 1:1 PSM. After PSM and multivariable adjustments, the association between chemotherapy and improved survival was even stronger in younger patients, but not in older (71 year) patients.

In conclusion, these findings suggest that chemotherapy should be considered as part of the treatment for metastatic urachal carcinoma, particularly in younger patients (age 70 years).

Reference

Flammia RS, Chierigo F, Würnschimmel C, Horlemann B, Hoeh B, Sorce G, Tian Z, Leonardo C, Tilki D, Terrone C, Saad F, Shariat SF, Montorsi F, Chun FK, Gallucci M, Karakiewicz PI. Survival benefit of chemotherapy in a contemporary cohort of metastatic urachal carcinoma. Urol Oncol. 2021 Oct 19:S1078-1439(21)00432-4. doi: 10.1016/j.urolonc.2021.09.008. Epub ahead of print. PMID: 34686429.