Department of Urology, Rush University, Chicago, IL, USA; Department of Urology, D'Annunzio University of Chieti-Pescara, Chieti, Italy.
Department of Urology, Rush University, Chicago, IL, USA; Division of Urology, Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy.
Clin Genitourin Cancer. 2024 Dec;22(6):102175. doi: 10.1016/j.clgc.2024.102175. Epub 2024 Jul 23.
Urachal carcinoma (UrC) is a rare, nonurothelial malignancy, comprising less than 1% of all bladder cancers. It usually affects males in their fifth to sixth decade and is often diagnosed at an advanced stage with metastasis. This study examines UrC population characteristics and management.
We identified UrC patients from bladder biopsies or TURB in the PearlDiver Mariner database (2010-2022). Descriptive statistics detailed patient characteristics. Student's T-Tests compared ages for partial vs. radical cystectomy, and Fisher's exact test compared SDOH presence. Significance was set at P < .05. Analyses used R version 3.6.0 within PearlDiver's software.
Among 2475 UrC patients (mean age 69.2 ± 9.2 years, 73.1% men), most were in the south (36.5%), outpatient settings (84.5%), and privately insured (65.3%). A total of 418 (16.2%) had at least 1 SDOH. Imaging before diagnosis was used in 65.74% of patients, primarily ultrasound. Smoking was present in 54.5%, diabetes in 42.9%, and obesity in 25.2%. After diagnosis, 1246 (50.34%) had localized disease; 407 underwent radical cystectomy and 330 partial cystectomy. Patients undergoing radical cystectomy were older (66.74 ± 8.13 years) compared to those undergoing partial cystectomy (60.55 ± 12.92 years) (P < .001), with SDOH factors more prevalent in the partial cystectomy group (P = .03).
UrC is a rare, often advanced-stage cancer predominantly affecting older men. Our study shows a trend towards partial cystectomy for localized UrC. Further research is needed to personalize surgery and integrate multidisciplinary approaches for better outcomes.
脐尿管癌（UrC）是一种罕见的非尿路上皮恶性肿瘤，占所有膀胱癌的比例不到 1%。它通常影响 50 至 60 岁的男性，并且经常在晚期转移时被诊断出来。本研究检查了 UrC 患者的人群特征和治疗方法。
我们从 PearlDiver Mariner 数据库（2010 年至 2022 年）中的膀胱活检或 TURB 中确定了 UrC 患者。描述性统计数据详细说明了患者的特征。学生 t 检验比较了部分和根治性膀胱切除术的年龄，Fisher 精确检验比较了 SDOH 存在的情况。显著性水平设定为 P <.05。分析使用了 PearlDiver 软件中的 R 版本 3.6.0。
在 2475 例 UrC 患者中（平均年龄 69.2 ± 9.2 岁，73.1%为男性），大多数患者来自南方（36.5%）、门诊（84.5%）和私人保险（65.3%）。共有 418 例（16.2%）存在至少 1 个 SDOH。在诊断前，65.74%的患者进行了影像学检查，主要是超声检查。54.5%的患者有吸烟史，42.9%的患者有糖尿病，25.2%的患者有肥胖症。诊断后，1246 例（50.34%）为局限性疾病；407 例患者接受了根治性膀胱切除术，330 例患者接受了部分膀胱切除术。接受根治性膀胱切除术的患者年龄较大（66.74 ± 8.13 岁），而接受部分膀胱切除术的患者年龄较小（60.55 ± 12.92 岁）（P <.001），部分膀胱切除术组的 SDOH 因素更为普遍（P =.03）。
UrC 是一种罕见的、通常为晚期的癌症，主要影响老年男性。我们的研究表明，局部 UrC 倾向于行部分膀胱切除术。需要进一步研究以实现手术个体化，并整合多学科方法以获得更好的结果。
