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Multicenter Study
. 2023 Oct;55(4):1337-1345.
doi: 10.4143/crt.2023.417. Epub 2023 Apr 17.

TNM-Based Head-to-Head Comparison of Urachal Carcinoma and Urothelial Bladder Cancer: Stage-Matched Analysis of a Large Multicenter National Cohort

Sang Hun Song  1   2 , Jaewon Lee  1 , Young Hwii Ko  3 , Jong Wook Kim  4 , Seung Il Jung  5 , Seok Ho Kang  6 , Jinsung Park  7 , Ho Kyung Seo  8 , Hyung Joon Kim  9 , Byong Chang Jeong  10 , Tae-Hwan Kim  11 , Se Young Choi  12 , Jong Kil Nam  13 , Ja Yoon Ku  14 , Kwan Joong Joo  15 , Won Sik Jang  16 , Young Eun Yoon  17 , Seok Joong Yun  18 , Sung-Hoo Hong  19 , Jong Jin Oh  1   2
Affiliations
Multicenter Study

TNM-Based Head-to-Head Comparison of Urachal Carcinoma and Urothelial Bladder Cancer: Stage-Matched Analysis of a Large Multicenter National Cohort

Sang Hun Song et al. Cancer Res Treat. 2023 Oct.

Abstract

Purpose: Outcome analysis of urachal cancer (UraC) is limited due to the scarcity of cases and different staging methods compared to urothelial bladder cancer (UroBC). We attempted to assess survival outcomes of UraC and compare to UroBC after stage-matched analyses.

Materials and methods: Total 203 UraC patients from a multicenter database and 373 UroBC patients in single institution from 2000 to 2018 were enrolled (median follow-up, 32 months). Sheldon stage conversion to corresponding TNM staging for UraC was conducted for head-to-head comparison to UroBC. Perioperative clinical variables and pathological results were recorded. Stage-matched analyses for survival by stage were conducted.

Results: UraC patients were younger (mean age, 54 vs. 67 years; p < 0.001), with 163 patients (80.3%) receiving partial cystectomy and 23 patients (11.3%) radical cystectomy. UraC was more likely to harbor ≥ pT3a tumors (78.8% vs. 41.8%). While 5-year recurrence-free survival, cancer-specific survival (CSS) and overall survival were comparable between two groups (63.4%, 67%, and 62.1% in UraC and 61.5%, 75.9%, and 67.8% in UroBC, respectively), generally favorable prognosis for UraC in lower stages (pT1-2) but unfavorable outcomes in higher stages (pT4) compared to UroBC was observed, although only 5-year CSS in ≥ pT4 showed statistical significance (p=0.028). Body mass index (hazard ratio [HR], 0.929), diabetes mellitus (HR, 1.921), pathologic T category (HR, 3.846), and lymphovascular invasion (HR, 1.993) were predictors of CSS for all patients.

Conclusion: Despite differing histology, UraC has comparable prognosis to UroBC with relatively favorable outcome in low stages but worse prognosis in higher stages. The presented system may be useful for future grading and risk stratification of UraC.

Keywords: Cystectomy; Neoplasm staging; Survival analysis; TNM classification; Urachal cancer; Urinary bladder neoplasms.

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Conflict of interest statement

Conflicts of Interest

Conflict of interest relevant to this article was not reported.

Figures

Fig. 1
Fig. 1
Recurrence-free survival (A), cancer-specific survival (B), and overall survival (C) comparison of urachal carcinoma (UraC) and urothelial bladder cancer (UroBC).
Fig. 2
Fig. 2
Recurrence-free survival, cancer-specific survival, and overall survival comparison of urachal carcinoma (UraC) and urothelial bladder cancer (UroBC) stratified by matched TNM staging.
See this image and copyright information in PMC

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