[Clinical analysis of 14 cases of urachal carcinoma].

BACKGROUND & OBJECTIVE Urachal carcinoma is a rare malignancy. This study was to summarize our clinical experience in the diagnosis and treatment of urachal carcinoma. METHODS Fourteen cases of urachal carcinoma treated from May 1994 to April 2007 at Cancer Center and The First Affiliated Hospital of Sun Yat-sen University were retrospectively reviewed and analyzed. RESULTS The most common complaints of the 14 patients were hematuria and irrigative bladder symptoms. Cystoscopy mainly revealed broad-based tumors located at the dome of the bladder. Soft-tissue masses between the bladder dome and the abdominal wall were detected by imaging examinations; the wall of the bladder was often invaded. Thirteen patients were found adenocarcinoma, the other one was malignant stromal cell tumor. Seven patients underwent extensive partial excision of the bladder, among which one case developed local recurrence 24 months after operation, while the other six cases were followed up for 14-120 months, with a median follow-up of 42 months without recurrence. Three patients underwent radical bladder resection and urinary diversion, two of which were followed up for 16 months and 84 months respectively without recurrence, while the other one died from surgical complications 3 months after operation. One case underwent partial cystectomy at another hospital developed recurrence 10 months after operation. Three advanced cancer patients received chemotherapy, two of which achieved progression free survival for seven and eight months respectively, while the other one died three months after chemotherapy. The one- and five-year survival rates were 85.7% and 61.2%, respectively. CONCLUSIONS Extensive partial excision of the bladder is recommended for urachal carcinoma. Radical removal of the tumor during the first treatment and comprehensive therapies for advanced cancer patients and patients with recurrence or metastasis after operation are critical to improve the treatment efficacy of urachal carcinoma.