Abstract 788P
Background
Urachal carcinoma (UrC) represents < 1 % of bladder carcinomas and is developed from an embryonic remnant connecting to the umbilicus. Because of its rarity, the standard of care is not well defined.
Methods
We identified patients (pts) treated for UrC by the GETUG-AFU group. Data were collected retrospectively and analyzed for pts characteristics and outcomes.
Results
Between 1996 and 2019, 76 pts were included from 16 hospitals in France. Median age at diagnosis was 55.5 years (26-86), including 53% of men. The ECOG was 0-1 (96%) and 32 % had tobacco-exposure. Pts with localized disease (n=60) were treated by partial cystectomy (n=43) or total cystectomy (n=10) (unknown for 7 pts), with lymphadenectomy (38%) and umbilical resection (52%). Adenocarcinoma represented 92% of UrC (40% mucinous), and rare variants 8%. One patient had adjuvant radiotherapy (n=1) and 10 pts (19%) received adjuvant chemotherapy (CT) : fluoro-uracil (FU) plus platin or irinotecan (n=7), anthracycline plus platin (n=2), unknown (n=1). Metastatic relapse occurred for 62% of pts (n=37). Metastatic disease was observed at diagnosis in 15 pts (20%). The predominant sites were peritoneum (62%) and lung (40%). The most common first-line of CT was FU-based regimen for 34 pts (65%), combined with platin (n=31) or irinotecan (n=3). Gemcitabine plus platin (n=7) or others CT were administered (n=4), unknown CT for 7 pts. For the whole population, median overall survival (OS) was 52 months (mo) (confidence interval 95%, 37-90). The median OS for localized disease was 60 mo (37-108) with no significant difference between partial or total cystectomy: 69 mo (52-NR) vs 37 mo (34-NR) respectively (p=0.7). Pts with pN+ had a lower median OS: 21 mo (9-NR) versus 73.5 mo (69-NR) for pN- (p=0.009). The median progression free survival for metastatic pts in first-line was 5 mo (3-11) and median OS was 22 mo (19-28).
Conclusions
UrC is a rare tumor, observed in younger age, more female and less tobacco exposure than urothelial carcinoma. Partial cystectomy is a surgical option for localized diseases and mucinous adenocarcinoma the predominant histology. FU-platin chemotherapy is the most frequently used. Improving our clinical and biological knowledge of this rare entity may improve specific care.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
E. Colomba-Blameble: Honoraria (self), Honoraria (institution), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Ipsen; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: BMS; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: PFIZER; Honoraria (self), Advisory/Consultancy: Sanofi; Honoraria (self), Advisory/Consultancy: GSK; Travel/Accommodation/Expenses: Novartis. D. Maillet: Honoraria (institution), Advisory/Consultancy, Travel/Accommodation/Expenses: Janssen; Advisory/Consultancy, Travel/Accommodation/Expenses: BMS; Advisory/Consultancy, Travel/Accommodation/Expenses: Pfizer; Advisory/Consultancy, Travel/Accommodation/Expenses: AstraZeneca; Advisory/Consultancy, Travel/Accommodation/Expenses: Sanofi; Advisory/Consultancy, Travel/Accommodation/Expenses: Ipsen; Advisory/Consultancy: Novartis; Advisory/Consultancy, Travel/Accommodation/Expenses: MSD. C. Thibault: Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Pfizer; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self), Advisory/Consultancy: Sanofi; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Janssen; Honoraria (self): Ipsen. E. Coquan: Advisory/Consultancy: MSD; Advisory/Consultancy: BMS; Advisory/Consultancy, Travel/Accommodation/Expenses: AstraZeneca; Travel/Accommodation/Expenses: Astellas; Research grant/Funding (institution), Travel/Accommodation/Expenses: Ipsen. C. Dumont: Travel/Accommodation/Expenses: Ipsen. D. Borchiellini: Advisory/Consultancy, Non-remunerated activity/ies: Astellas; Advisory/Consultancy, Non-remunerated activity/ies: AstraZeneca; Non-remunerated activity/ies: Calithera; Advisory/Consultancy, Travel/Accommodation/Expenses, Non-remunerated activity/ies: BMS; Advisory/Consultancy: Ipsen; Advisory/Consultancy, Travel/Accommodation/Expenses, Non-remunerated activity/ies: Janssen; Advisory/Consultancy, Non-remunerated activity/ies: MSD; Advisory/Consultancy: Novartis; Advisory/Consultancy, Travel/Accommodation/Expenses, Non-remunerated activity/ies: Pfizer; Advisory/Consultancy, Travel/Accommodation/Expenses, Non-remunerated activity/ies: Roche; Non-remunerated activity/ies: Exelixis; Non-remunerated activity/ies: Sanofi; Non-remunerated activity/ies: Infinity; Non-remunerated activity/ies: Merck KGaA. A. Khalil: Advisory/Consultancy: Pfizer; Advisory/Consultancy: Servier; Advisory/Consultancy, Speaker Bureau/Expert testimony: Astellas; Advisory/Consultancy, Travel/Accommodation/Expenses: Janssen. G. Baciarello: Honoraria (self), Honoraria (institution), Travel/Accommodation/Expenses: Janssen; Honoraria (self), Honoraria (institution), Travel/Accommodation/Expenses: Roche; Honoraria (institution): Amgen; Honoraria (institution), Travel/Accommodation/Expenses: Astellas Oncology; Travel/Accommodation/Expenses: Ipsen. G. Gravis: Honoraria (institution), Advisory/Consultancy, Travel/Accommodation/Expenses: Pfizer; Honoraria (institution), Advisory/Consultancy, Travel/Accommodation/Expenses: BMS; Honoraria (institution), Travel/Accommodation/Expenses: MSD; Honoraria (institution), Advisory/Consultancy, Travel/Accommodation/Expenses: AstraZeneca; Honoraria (institution): Astellas; Honoraria (institution), Advisory/Consultancy, Travel/Accommodation/Expenses: Janssen; Honoraria (institution), Advisory/Consultancy: Bayer; Honoraria (institution), Travel/Accommodation/Expenses: Sanofi; Advisory/Consultancy, Travel/Accommodation/Expenses: Ipsen. All other authors have declared no conflicts of interest.