Urachal carcinoma: contemporary surgical outcomes.

Objective: We determined surgical outcomes in a contemporary series of patients who underwent surgery for urachal carcinoma.

Methods: A cohort of 50 patients with clinically staged localized urachal carcinoma underwent extended partial cystectomy, including the urachal tumor mass and entire urachus. The patients were followed a median of 5+ years for cancer-free survival.

Results: Of the 50 patients 93% (26 of 28) with tumor confined to the urachus and bladder survived compared to 69% (9 of 13) with extravesical or peri-urachal tumor invasion and none (9 patients) with tumor invasion into the peritoneal cavity. Local recurrence was noted in 9 patients (18%) and 2 had salvage therapy. The most significant predictors of survival were pathological tumor stage and negative surgical margins.

Conclusions: Wide resection of the tumor mass and entire urachus resulting in negative soft tissue and bladder margins cures the majority of nonmetastatic urachal cancers.