Demographic Profiles and Survival Outcomes of Patients With Urachal Adenocarcinoma: A Rare Tumor of the Urachal Remnant

Twenty patients of urachal adenocarcinoma diagnosed at our institute presented with Mayo 1 to 3 stage in 90% of the cases. Median disease-free survival (DFS) was improved with the use of adjuvant chemotherapy. After a median follow-up of 26.5 months, the median overall survival (OS) after the diagnosis of metastasis was 13 months, while the median OS of the entire cohort was 42 months. Background: Urachal adenocarcinoma is a rare cancer of a urachal remnant with limited literature and a lack of random-ized prospective studies. Materials and Methods: The data of urachal adenocarcinoma cases diagnosed at our institute from January 2013 to March 2021 were retrieved from the electronic medical records. Demographic data were presented using descriptive statistics and simple percentages; survival was calculated using the Kaplan-Meier method. Results: The median age of twenty patients included in the study was 46.5 years with an almost equal male-to-female distri-bution. Eighteen (90%) patients were diagnosed with Mayo stage 1 to 3 disease at presentation; all of these patients underwent surgical resection of the tumor, while only 8 patients received adjuvant chemotherapy. After a median follow-up of 26.5 months, treatment failure occurred in 7 (38.8%) patients at a median of 12 months. The median disease-free survival (DFS) was 14 (95% CI, 9.1-18.8) months for the 10 patients who did not receive adjuvant chemotherapy, while it was not reached for the 8 patients who received adjuvant chemotherapy. The median progression-free survival (PFS) for the 8 patients treated with palliative chemotherapy was 3 (95% CI, 0-9.5) months and the median overall survival (OS) after the diagnosis of metastasis was 13 (95% CI: 10.1-15.9) months. The median OS of the entire cohort was 42 (95% CI: 20.8-63.2) months. Conclusion: Urachal adenocarcinoma requires multimodality management with the incor-poration of adjuvant chemotherapy to achieve favorable clinical outcomes. Further collaborative studies are required to improve survival in this rare cancer.