Urachal Cancer Prognosis Better Than Expected

Author: By Lynda Williams, Senior medwireNews Reporter 

medwireNews: Patients with urachal cancer may have a better prognosis than previously expected, suggests a study of US individuals who were treated for the rare genitourinary tumour between 1988 and 2019. 

The findings were reported at the ESMO Congress 2022 in Paris, France, by David Benjamin, from the Hoag Family Cancer Institute in Newport Beach, California, USA, and published simultaneously in a research letter to JAMA Oncology. 

The investigators explain that urachal cancer is “considered an extremely aggressive neoplasm, with a median overall survival (OS) ranging between 12 and 24 months among patients with locally advanced and metastatic disease.” 

However, the team now reports a median OS of 76 months among their study population of 315 Californian patients, with localised or in situ (n=103), regional (n=119) or remote (n=85) disease at time of diagnosis recorded. 

The majority (88.89%) of patients had surgery for their primary tumour, while 25.71% were given chemotherapy, 8.25% radiotherapy and 2.54% immunotherapy. At last follow-up, 41.59% of patients were alive, 32.28% had died from urachal cancer, 22.54% from another cause, and death was from an unknown cause in 3.49% of cases. 

Over half (56.51%) of the patients in the analysis were men, the average age was 57.98 years, and the majority were non-Hispanic White (60.32%), while smaller numbers of patients were Hispanic (18.41%), Asian/Pacific Islander (14.29%) or non-Hispanic Black (6.03%). 

The team also collected information on neighbourhood socioeconomic status, finding that 25.71% of patients were in the highest quintile, 24.76% the upper-middle, 21.90% the middle, 13.97% the lower-middle and 11.43% the lowest quintile. 

Kaplan–Meier analysis did not find any significant association between OS and sex, race/ethnicity or neighbourhood socioeconomic status.  

But median OS was significantly better among patients aged 60–69 years than younger or older individuals (median 223 vs 19–106 months), and among individuals with in situ or localised versus regional or remote (median 178 vs 83 and 19 months, respectively) tumours.  

OS was also significantly better among patients who were married or had a domestic partner compared with single, divorced or widowed patients (median 102 vs 42 months) and in those with private health insurance or Medicare with private supplement compared with Medicare without supplement (median 144 vs 53 months).
 

References  

1766P - Benjamin DJ, Shrestha A, Fellman D, et al. Urachal cancer: a population-based study of 315 cases in California from 1988-2019. Ann Oncol 2022; 33 (suppl_7): S785–S807. Doi: 10.1016/annonc/annonc1080

Benjamin DJ, Shrestha A, Fellman D, et al. Association of sociodemographic characteristics with survival among patients with urachal cancer in California from 1988 to 2019. JAMA Oncol; Advance online publication 12 September 2022. doi:10.1001/jamaoncol.2022.3252