Outcomes of Korean patients with clinically localized urachal or non-urachal adenocarcinoma of the bladder.

OBJECTIVE: This study aimed to investigate whether there is a difference between clinically localized urachal and non-urachal adenocarcinomas in terms of patient survival.
METHODS: A total of 31 patients without evidence of distant metastasis who were treated by radical or partial cystectomy were included in the study. Of the 31 cases, 17 and 14 fulfilled the histologic criteria for urachal and non-urachal carcinoma, respectively. The mean follow-up period was 54.2 months (range: 6.6-188.8).
RESULTS: Patients with urachal adenocarcinoma were significantly younger than patients with non-urachal adenocarcinomas (45.7 vs. 70.0 years; P = 0.002). The rates of local or distant recurrence were similar (47.1 vs. 50.0%; P = 0.507, log-rank test). Patients with ≤ 4-cm tumors had a better disease-free survival than those with >4-cm tumors (P = 0.043, log-rank test). Patients with mucinous type adenocarcinoma tended to have better disease-free survival than those with other histologic types of adenocarcinoma (P = 0.064, log-rank test). Multivariate Cox regression analysis revealed that only tumor size and histologic type could predict the disease-free survival after surgery of patients with primary adenocarcinoma.
CONCLUSIONS: Our findings suggest that the disease-free survivals associated with urachal and non-urachal adenocarcinoma do not differ significantly but that attempts should be made to diagnose these aggressive tumors early, when they are more likely to be small, since the survivors without disease after surgery appear to be patients in whom the tumor was small.