AUTHOR=Yu Young Dong , Ko Young Hwii , Kim Jong Wook , Jung Seung Il , Kang Seok Ho , Park Jinsung , Seo Ho Kyung , Kim Hyung Joon , Jeong Byong Chang , Kim Tae-Hwan , Choi Se Young , Nam Jong Kil , Ku Ja Yoon , Joo Kwan Joong , Jang Won Sik , Yoon Young Eun , Yun Seok Joong , Hong Sung-Hoo , Oh Jong Jin 

TITLE=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

JOURNAL=Frontiers in Oncology

VOLUME=Volume 11 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.683190

DOI=10.3389/fonc.2021.683190

ISSN=2234-943X

ABSTRACT=Aim: This study evaluated the prognosis and survival predictors for bladder urachal carcinoma (UC), based on large scaled multicenter cohort with long term follow-up database. 
Methods: 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.
Results: The mean age of the patients were 54.2 years. Among total 203 patients, stage I, II, III and IV (Mayo stage) was 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.
Conclusion: The 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.