Published in:
01-11-2020 | Cystectomy | Original Article
Survival of contemporary patients with non-metastatic urachal vs. non-urachal adenocarcinoma of the urinary bladder
Authors:
Stefano Luzzago, Carlotta Palumbo, Giuseppe Rosiello, Angela Pecoraro, Marina Deuker, Francesco Alessandro Mistretta, Zhe Tian, Gennaro Musi, Emanuele Montanari, Shahrokh F. Shariat, Fred Saad, Alberto Briganti, Ottavio de Cobelli, Pierre I. Karakiewicz
Published in:
World Journal of Urology
|
Issue 11/2020
Login to get access
Abstract
Purpose
To test the effect of tumor location (urachal vs. non-urachal) on cancer-specific mortality (CSM) in patients with adenocarcinoma of the urinary bladder (ADKUB).
Materials and methods
Within the Surveillance, Epidemiology, and End Results registry (2004–2016), we identified patients with non-metastatic (≤ T4N0M0) ADKUB. Stratification was made according to tumor location: urachal vs. non-urachal ADKUB. Kaplan–Meier plots and multivariable Cox regression models were fitted before and after 1:3 propensity score (PS) matching and separate Cox regression models were refitted before and after inverse probability of treatment weighting (IPTW).
Results
Of 1681 patients, 226 (13.5%) vs. 1455 (86.5%) harboured urachal vs. non-urachal ADKUB, respectively. Five-year cancer-specific survival (CSS) rates were, respectively, 75 vs. 67% for urachal vs. non-urachal ADKUB (p = 0.001). In subgroup analyses of ≤ T2N0M0 patients, 5-year CSS rates were, respectively, 84 vs. 73% for urachal vs. non-urachal ADKUB (p = 0.006). In subgroup analyses of T3-4N0M0 patients, 5-year CSS rates were, respectively, 68 vs. 49% for urachal vs. non-urachal ADKUB (p < 0.001). In multivariable Cox regression models, urachal ADKUB was associated with lower CSM rates (HR 0.6; p = 0.01). Virtually, the same findings were recorded after 1:3 PS matching (HR 0.6; p = 0.009) as well as when Cox regression models were refitted after IPTW (HR 0.7; p = 0.01).
Conclusion
The distinction between urachal vs. non-urachal ADKUB indicates better prognosis when the origin of the tumor is urachal, regardless of methodological approach used for the comparison.