原發性膀胱腺癌與臍尿管腺癌的預後比較-單一中心報告

徐明蔚、楊啟瑞、吳錫金、黃志平、陳冠亨、蕭博任、張兆祥

中國醫藥大學附設醫院 泌尿部

Oncological outcomes of primary bladder adenocarcinoma and urachal adenocarcinoma in a single center

Ming-Wei Hsu, Chi-Rei Yang, Hsi-Chin Wu, Chi-Ping Huang, Guan-Heng Chen, Po-Jen Hsiao, Chao-Hsiang Chang

Department of Urology, China Medical University Hospital, Taichung, Taiwan

Purpose

Adenocarcinoma is a rare type of malignancy affecting the urinary bladder, which can either originate within the bladder itself or develop as a secondary cancer from various other organs. Primary bladder adenocarcinoma typically presents a poor prognosis, primarily because it tends to be diagnosed in advanced stages. On the other hand, urachal adenocarcinoma shares histological similarities with bladder adenocarcinoma but offers a more favorable prognosis, partly attributed to the relatively younger age of patients affected by urachal adenocarcinoma. In our institution, we aim to conduct a comparative analysis of the treatment approaches and prognostic outcomes for these two related malignancies.

Materials and Methods:

We identified 18 patients with urinary bladder adenocarcinoma at our hospital from 2011 to 2023. All of them are muscle invasice cancer, of which 8 are primary bladder adenocarcinoma and 10 are urachal adenocarcinoma. We compare the overall survival, progression free survival and recurrence pattern including local recurrence and metastasis.

Results

The median postoperative follow-up period was 27 months. Upon diagnosis, all of them are muscle invasive adenocarcimona; 2 of bladder adenocarcinoma and 1 of urachal carcinoma had distant metastasis. When comparing patients with primary bladder adenocarcinoma to those with urachal adenocarcinoma, median overall survival was 27 months vs 32 months. Median progression-free survival was 17 months vs 15 months. 3-year overall survival rates showed 37.5% vs 50% without significant difference. Furthermore, among the patients with recurrence, all patients experienced distant metastasis, and 2 patients with urachal adenocanrcinoma experienced local recurrence.

Conclusion:

Both primary bladder adenocarcinoma and urachal adenocarcinoma exhibited a challenging prognosis, primarily attributed to their late-stage diagnosis, resulting in a 3-year survival rate of less than 50 percent. Besides, distant metastasis was the most frequent progression pattern.