Differences in survival among patients with urachal and nonurachal adenocarcinomas of the bladder

Abstract

A total of 151 urachal and 1374 nonurachal adenocarcinomas of the bladder patients were identified. Compared to those with nonurachal tumors, patients with urachal adenocarcinoma were more likely to be younger (median age, 56 vs. 69 years, P <.0001) and female (45% vs. 36%, P = .02). Urachal lesions were less likely to be high grade (35% vs. 66%, P < .001), but more likely to involve distant metastases (30% vs. 15%, P < .001). Partial cystectomy was more common in urachal tumors (66% vs. 16%, P <.001). In multivariate analysis, subjects with urachal tumors had a lower risk of all cause (hazard ratio [HR] = 0.56, 95% confidence interval [CI]: 0.38-0.83) and disease-specific (HR = 0.59, 95% CI: 0.35-0.98) mortality compared with patients with nonurachal tumors. CONCLUSIONS. Urachal adenocarcinomas represent 10% of all primary adenocarcinomas of the bladder. Overall and disease-specific mortality risks are improved in patients with urachal lesions, even after controlling for numerous patient and tumor characteristics.