Konstantinos S Mylonas1, Padraic O Malley2, Ioannis A Ziogas1, Lamis El-Kabab3, Dimitrios Nasioudis4. 1. Surgery Working Group, Society of Junior Doctors, Athens, Greece; Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece. 2. Department of Urology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA; Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada. 3. Surgery Working Group, Society of Junior Doctors, Athens, Greece. 4. Surgery Working Group, Society of Junior Doctors, Athens, Greece; Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA. Electronic address: dnasioudis@sni.gr.
Abstract
OBJECTIVES: To examine patient and clinicopathological features of malignant urachal neoplasms (MUN) in a population-based cohort, to investigate survival outcomes, and to review the current evidence that exists in the literature. MATERIAL AND METHODS: The Surveillance, Epidemiology, and End Results database was used to identify microscopically confirmed MUN cases diagnosed between 1988 and 2012. Kaplan-Meier analysis was used to determine median and 5-year overall survival (OS) as well as cancer-specific survival (CSS) rates. Cox proportional hazards model was employed to identify variables independently associated with cancer-specific mortality. A systematic literature review was conducted in line with the PRISMA statement. RESULTS: A total of 420 patients with MUNs were identified. The majority were white (77.6%) and male patients (59%) who presented with low-grade (62.1%), mucinous, noncystic adenocarcinomas (42.9%). From the cohort, 19%, 15.2%, 29.5%, and 30.5% of the patients presented with American Joint Committee on Cancer Stage I to IV disease, respectively. Cancer-directed surgery was performed in 86.5% of the patients. The most common procedure performed was partial cystectomy (52.4%) followed by local tumor excision (20.7%). Median OS was 57 months (95% CI: 41.6-72.4), and median CSS was 105 months (95% CI: 61.5-148.5). Five-year OS and CSS rates were 51% and 57%, respectively. Grade and stage were independently associated with cancer-specific mortality. Mortality rates did not differ between patients who underwent partial cystectomy and radical cystectomy/exenteration (P = 0.165), even after controlling for tumor stage. A total of 16 studies reporting on 585 patients were systematically reviewed, and relevant outcomes were summarized in the Supplemental material. CONCLUSIONS: MUNs are usually low-grade, mucinous, noncystic adenocarcinomas diagnosed at advanced stages. Overall, the prognosis is poor, and high-grade and disease stage are independently associated with cancer-specific mortality.
OBJECTIVES: To examine patient and clinicopathological features of malignant urachal neoplasms (MUN) in a population-based cohort, to investigate survival outcomes, and to review the current evidence that exists in the literature. MATERIAL AND METHODS: The Surveillance, Epidemiology, and End Results database was used to identify microscopically confirmed MUN cases diagnosed between 1988 and 2012. Kaplan-Meier analysis was used to determine median and 5-year overall survival (OS) as well as cancer-specific survival (CSS) rates. Cox proportional hazards model was employed to identify variables independently associated with cancer-specific mortality. A systematic literature review was conducted in line with the PRISMA statement. RESULTS: A total of 420 patients with MUNs were identified. The majority were white (77.6%) and male patients (59%) who presented with low-grade (62.1%), mucinous, noncystic adenocarcinomas (42.9%). From the cohort, 19%, 15.2%, 29.5%, and 30.5% of the patients presented with American Joint Committee on Cancer Stage I to IV disease, respectively. Cancer-directed surgery was performed in 86.5% of the patients. The most common procedure performed was partial cystectomy (52.4%) followed by local tumor excision (20.7%). Median OS was 57 months (95% CI: 41.6-72.4), and median CSS was 105 months (95% CI: 61.5-148.5). Five-year OS and CSS rates were 51% and 57%, respectively. Grade and stage were independently associated with cancer-specific mortality. Mortality rates did not differ between patients who underwent partial cystectomy and radical cystectomy/exenteration (P = 0.165), even after controlling for tumor stage. A total of 16 studies reporting on 585 patients were systematically reviewed, and relevant outcomes were summarized in the Supplemental material. CONCLUSIONS: MUNs are usually low-grade, mucinous, noncystic adenocarcinomas diagnosed at advanced stages. Overall, the prognosis is poor, and high-grade and disease stage are independently associated with cancer-specific mortality.
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: Rami Mäkelä; Antti Arjonen; Ville Härmä; Nina Rintanen; Lauri Paasonen; Tobias Paprotka; Kerstin Rönsch; Teijo Kuopio; Juha Kononen; Juha K Rantala Journal: BMC Cancer Date: 2020-06-23 Impact factor: 4.430
Authors: Young Dong Yu; Young Hwii Ko; Jong Wook Kim; Seung Il Jung; Seok Ho Kang; Jinsung Park; Ho Kyung Seo; Hyung Joon Kim; Byong Chang Jeong; Tae-Hwan Kim; Se Young Choi; Jong Kil Nam; Ja Yoon Ku; Kwan Joong Joo; Won Sik Jang; Young Eun Yoon; Seok Joong Yun; Sung-Hoo Hong; Jong Jin Oh Journal: Front Oncol Date: 2021-05-31 Impact factor: 6.244