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20.01.2020 | Original Article | Ausgabe 11/2020

World Journal of Urology 11/2020

Survival of contemporary patients with non-metastatic urachal vs. non-urachal adenocarcinoma of the urinary bladder

Zeitschrift:
World Journal of Urology > Ausgabe 11/2020
Autoren:
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
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00345-020-03083-5) contains supplementary material, which is available to authorized users.

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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.

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