Pinthus Jehonathan H, Haddad Riad, Trachtenberg John, Holowaty Eric, Bowler Jeff, Herzenberg Andrew M, Jewett Michael, Fleshner Neil E
Department of Surgical Oncology (Division of Urology), University Health Network, University of Toronto, Toronto, Ontario, Canada.
J Urol. 2006 Jun;175(6):2042-7; discussion 2047. doi: 10.1016/S0022-5347(06)00263-1.
Urachal carcinoma accounts for less than 1% of all bladder cancers. Limited data exist on disease related outcomes originating from case reports and select referral centers. We describe a population based outcomes analysis with long-term followup in patients in the province of Ontario.
We reviewed the data source of the Ontario Cancer Registry for patients diagnosed with urachal cancer during 1976 to 2001. A cohort of 40 patients with urachal adenocarcinoma was found. Primary outcome measures were overall and disease specific survival. The effect of patient age, sex, grade, stage and university vs nonacademic treating hospital as predictors of outcome was determined.
Median patient age was 52 years. Median followup was 72.7 months. Mean overall survival +/- SD was 121.6 +/- 21 months. Mean disease specific survival in patients treated operatively was 165 +/- 27 months with 5 and 10-year disease specific survival of 61.3% and 49.2%, respectively. Disease specific mortality was not evident after 7 years from diagnosis. Well differentiated tumors in a third of the patients were associated with a 90% cure rate when treated operatively. Well differentiated tumors, and noninvolvement of adjacent organs and the peritoneum correlated with better prognosis (p = 0.004, p = 0.03 and 0.045, respectively).
Urachal adenocarcinoma occurs in all age groups. Long-term disease specific survival can be achieved with partial cystectomy. Covariates associated with better disease specific survival are well differentiated tumor grade and the absence of adjacent organ or peritoneal involvement. No relapses were observed after 7 years.
脐尿管癌占所有膀胱癌的比例不到1%。源于病例报告和特定转诊中心的疾病相关结局数据有限。我们描述了安大略省患者基于人群的结局分析及长期随访情况。
我们回顾了安大略癌症登记处1976年至2001年期间诊断为脐尿管癌患者的数据源。发现了一组40例脐尿管腺癌患者。主要结局指标为总生存率和疾病特异性生存率。确定了患者年龄、性别、分级、分期以及治疗医院是大学附属医院还是非学术性医院作为结局预测因素的影响。
患者中位年龄为52岁。中位随访时间为72.7个月。平均总生存时间±标准差为121.6±21个月。接受手术治疗患者的平均疾病特异性生存时间为165±27个月，5年和10年疾病特异性生存率分别为61.3%和49.2%。诊断后7年未出现疾病特异性死亡。三分之一患者中的高分化肿瘤手术治疗后治愈率为90%。高分化肿瘤、未累及相邻器官和腹膜与较好的预后相关（分别为p = 0.004、p = 0.03和0.045）。
脐尿管腺癌发生于所有年龄组。部分膀胱切除术可实现长期疾病特异性生存。与较好疾病特异性生存相关的协变量是高分化肿瘤分级以及未累及相邻器官或腹膜。7年后未观察到复发。
