Taktak Samih, El-Taji Omar, Hanchanale Vishwanath
Department of Urology, Royal Liverpool University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
Curr Urol. 2023 Sep;17(3):188-192. doi: 10.1097/CU9.0000000000000189. Epub 2023 Mar 11.
We sought to evaluate modern diagnostic and treatment options for urachal adenocarcinoma (UAC) and to provide clarity regarding the available options and their outcomes for this poorly understood yet damaging disease.
We conducted a systematic literature search in PubMed and Medline focusing on updated management of UAC.
Surgical intervention continues to be the mainstay of treatment for localized UAC. However, with the increased availability of molecular and genetic profiling, chemotherapy has consistently demonstrated promising response rates and survival outcomes, especially for a disease that commonly presents in a metastatic stage. The role of checkpoint inhibitors remains under investigation. Cross-sectional imaging is vital during postoperative surveillance. However, there may also be a role for the adoption of cystoscopy to detect bladder recurrence.
Although the importance of surgical resection remains unchanged, improved survival outcomes with chemotherapy have been found in small retrospective studies. Randomized trial data are required to further assess the influence of systemic treatment as a primary or adjuvant therapy. Moreover, a stringent follow-up regimen incorporating evaluation for distant and local recurrence of UAC must be evaluated and adopted.
我们试图评估脐尿管腺癌（UAC）的现代诊断和治疗选择，并明确针对这种了解不足但危害极大的疾病的现有选择及其结果。
我们在PubMed和Medline上进行了系统的文献检索，重点关注UAC的最新管理。
手术干预仍然是局限性UAC治疗的主要手段。然而，随着分子和基因检测的可用性增加，化疗一直显示出有前景的缓解率和生存结果，特别是对于通常在转移阶段出现的疾病。检查点抑制剂的作用仍在研究中。横断面成像在术后监测中至关重要。然而，膀胱镜检查在检测膀胱复发方面可能也有作用。
虽然手术切除的重要性保持不变，但在小型回顾性研究中发现化疗可改善生存结果。需要随机试验数据来进一步评估全身治疗作为主要或辅助治疗的影响。此外，必须评估并采用严格的随访方案，包括对UAC远处和局部复发的评估。
