BACKGROUND AND OBJECTIVES: Urachal adenocarcinoma with peritoneal dissemination is an unusual presentation of a rare disease. It is associated with patients experiencing significant pain, poor outcomes, and historical median survival times between 12 and 24 months. We describe our 18-year experience in managing these patients with cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: Five patients who underwent six CRS with HIPEC for disseminated urachal cancer were identified. Demographics, perioperative data, and oncologic results were reviewed. RESULTS: All patients successfully completed CRS followed by HIPEC with Mitomycin C. Three patients had prior urachal mass excision and one had previous cystoprostatectomy with ileal conduit. At time of surgery, complete resection of all visible disease was only achieved in two patients. All patients developed local or distant disease recurrence at a median of 13 months postoperatively (range 7-31). The majority of patients (3/5) underwent postoperative intravenous chemotherapy for recurrence (2) or residual disease (1). All patients died of their disease, with median survival following date of surgery of 27 months (range 21-87). Symptomatic control of peritoneal disease was achieved in 2/5 (40%) of the cases. CONCLUSIONS: Urachal adenocarcinoma with peritoneal dissemination is an aggressive, rare disease, which is uniformly fatal. In our experience, CRS followed by HIPEC with Mitomycin C may increase patient survival and palliation, although further treatment improvements are clearly required.
BACKGROUND AND OBJECTIVES:Urachal adenocarcinoma with peritoneal dissemination is an unusual presentation of a rare disease. It is associated with patients experiencing significant pain, poor outcomes, and historical median survival times between 12 and 24 months. We describe our 18-year experience in managing these patients with cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: Five patients who underwent six CRS with HIPEC for disseminated urachal cancer were identified. Demographics, perioperative data, and oncologic results were reviewed. RESULTS: All patients successfully completed CRS followed by HIPEC with Mitomycin C. Three patients had prior urachal mass excision and one had previous cystoprostatectomy with ileal conduit. At time of surgery, complete resection of all visible disease was only achieved in two patients. All patients developed local or distant disease recurrence at a median of 13 months postoperatively (range 7-31). The majority of patients (3/5) underwent postoperative intravenous chemotherapy for recurrence (2) or residual disease (1). All patients died of their disease, with median survival following date of surgery of 27 months (range 21-87). Symptomatic control of peritoneal disease was achieved in 2/5 (40%) of the cases. CONCLUSIONS:Urachal adenocarcinoma with peritoneal dissemination is an aggressive, rare disease, which is uniformly fatal. In our experience, CRS followed by HIPEC with Mitomycin C may increase patient survival and palliation, although further treatment improvements are clearly required.
Authors: Mélanie Claps; Marco Stellato; Emma Zattarin; Alessia Mennitto; Pierangela Sepe; Valentina Guadalupi; Roberta Mennitto; Filippo G M de Braud; Elena Verzoni; Giuseppe Procopio Journal: Curr Oncol Rep Date: 2020-01-27 Impact factor: 5.075
Authors: Edward A Levine; John H Stewart; Perry Shen; Gregory B Russell; Brian L Loggie; Konstantinos I Votanopoulos Journal: J Am Coll Surg Date: 2013-12-21 Impact factor: 6.113
Authors: Henning Reis; Ulrich Krafft; Christian Niedworok; Orsolya Módos; Thomas Herold; Mark Behrendt; Hikmat Al-Ahmadie; Boris Hadaschik; Peter Nyirady; Tibor Szarvas Journal: Dis Markers Date: 2018-03-12 Impact factor: 3.434