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Chen H, Wu M, Chen M. Evaluation of the Management of Urachal Carcinoma: A Single-Center Experience over 13 Years. Urol Int 2024:1-9. [PMID: 38964295 DOI: 10.1159/000539760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/08/2024] [Indexed: 07/06/2024]
Abstract
INTRODUCTION Urachal carcinoma is characterized by high malignancy, poor prognosis, and late stage of diagnosis. There is a lack of unanimous clinical treatment guidelines. We summarize the characteristics, treatment, and outcomes of urachal carcinoma from our center, hoping to provide a reference for diagnosis and treatment. METHODS We retrospectively analyzed the clinical data of 21 patients with urachal carcinoma who were treated at our center from January 2010 to August 2022, and all patients were followed up. RESULTS The average survival time was 67.1 ± 9.1 (ranging from 49.3 to 84.9) months. The average relapse-free survival was 48.8 ± 9.9 (ranging from 29.5 to 68.2) months. Six patients received adjuvant therapy, mainly chemotherapy. Five patients died during follow-up. CONCLUSIONS Early physical examination may be helpful for early detection of urachal carcinoma. Surgical treatment is still preferred for localized urachal carcinoma. Lymph node dissection may facilitate accurate staging, and positive margin usually results in a worse prognosis. Adjuvant therapy, mainly chemotherapy, may help improve the prognosis. The application of radiotherapy, targeted therapy, and immunotherapy still needs further exploration.
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Affiliation(s)
- Hengxin Chen
- Department of Urology, Liuzhou Traditional Chinese Medical Hospital, Liuzhou, China,
| | - Menghai Wu
- Department of Urology, Xiangya Hospital Central South University, Changsha, China
| | - Minfeng Chen
- Department of Urology, Xiangya Hospital Central South University, Changsha, China
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Duan M, Liu H, Xu S, Yang Z, Zhang F, Wang G, Wang Y, Zhao S, Jiang X. IGF2BPs as novel m 6A readers: Diverse roles in regulating cancer cell biological functions, hypoxia adaptation, metabolism, and immunosuppressive tumor microenvironment. Genes Dis 2024; 11:890-920. [PMID: 37692485 PMCID: PMC10491980 DOI: 10.1016/j.gendis.2023.06.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/24/2023] [Accepted: 06/14/2023] [Indexed: 09/12/2023] Open
Abstract
m6A methylation is the most frequent modification of mRNA in eukaryotes and plays a crucial role in cancer progression by regulating biological functions. Insulin-like growth factor 2 mRNA-binding proteins (IGF2BP) are newly identified m6A 'readers'. They belong to a family of RNA-binding proteins, which bind to the m6A sites on different RNA sequences and stabilize them to promote cancer progression. In this review, we summarize the mechanisms by which different upstream factors regulate IGF2BP in cancer. The current literature analyzed here reveals that the IGF2BP family proteins promote cancer cell proliferation, survival, and chemoresistance, inhibit apoptosis, and are also associated with cancer glycolysis, angiogenesis, and the immune response in the tumor microenvironment. Therefore, with the discovery of their role as 'readers' of m6A and the characteristic re-expression of IGF2BPs in cancers, it is important to elucidate their mechanism of action in the immunosuppressive tumor microenvironment. We also describe in detail the regulatory and interaction network of the IGF2BP family in downstream target RNAs and discuss their potential clinical applications as diagnostic and prognostic markers, as well as recent advances in IGF2BP biology and associated therapeutic value.
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Affiliation(s)
- Meiqi Duan
- Department of General Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning 110032, China
| | - Haiyang Liu
- Department of General Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning 110032, China
| | - Shasha Xu
- Department of Gastroendoscopy, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning 110032, China
| | - Zhi Yang
- Department of General Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning 110032, China
| | - Fusheng Zhang
- Department of General Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning 110032, China
| | - Guang Wang
- Department of General Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning 110032, China
| | - Yutian Wang
- Department of General Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning 110032, China
| | - Shan Zhao
- Department of Rheumatology and Immunology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110002, China
| | - Xiaofeng Jiang
- Department of General Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning 110032, China
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3
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Urachal carcinoma: The journey so far and the road ahead. Pathol Res Pract 2023; 243:154379. [PMID: 36821941 DOI: 10.1016/j.prp.2023.154379] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023]
Abstract
Urachal carcinoma, a rare cancer arising from urachus, accounts for about 1% of bladder cancer. The diagnosis at stage I shows about 63% 5-year survival whereas only 8% of the patients at stage IV shows a 5-year survival. Above 90% of urachal carcinomas are adenocarcinomas and most of the urachal carcinoma cases are invasive, showing a high resemblance to adenocarcinoma of various origins, making it hard for a conclusive diagnosis. Even though inconclusive, immunohistochemistry can play a significant role in identifying urachal carcinoma. Most cases show the biomarkers CK20 and CDX2, whereas CK7 and β-catenin are expressed at a lesser frequency. Due to the few cases available, there is a lack of evidence regarding specific markers differentiating urachal carcinoma from colorectal or primary bladder adenocarcinomas. In addition to immunohistochemistry, genomic characterization is emerging to play a role in the classification and treatment of the disease. Urachal carcinoma has been reported to have a molecular level similarity with colorectal malignancies regarding certain gene expressions. The TP53 mutations inactivating the tumor suppressor can probably be explored as a possible target in treating urachal carcinoma. Additionally, certain targets identified in gastric and breast cancer along with anti-HER2 treatment strategies can be explored. Immuno-oncology utilizes immune checkpoint inhibitors for the treatment of MSI-H tumors whereas a combination of tyrosine kinase inhibitors along with immune checkpoint inhibitors are being studied to treat MSI stable tumors. The article is an in-depth overview of urachal carcinoma addressing the current landscape with an emphasis on the future scenario.
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Ke C, Xu L, Wang M, Wang Y, Zhou Q, Chen J, Wang Z, Wang S, Hu Z, Yang C. Treatment options and prognostic risk factors for urachal carcinoma: A multicetnter retrospective study. Urol Oncol 2023; 41:50.e1-50.e9. [PMID: 36283930 DOI: 10.1016/j.urolonc.2022.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/06/2022] [Accepted: 09/22/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Urachal carcinoma (UC) is a rare genitourinary cancer with an insidious onset, high risk of recurrence, and a poor prognosis. Surgical resection alone has difficulty in controlling the tumor. We aim to explore treatment options and prognostic risk factors for UC based on a multicenter cohort and long-term follow-up database. MATERIALS AND METHODS The clinical data, treatment and follow-up results of 163 patients with UC in 6 medical centers were analyzed retrospectively. Kaplan-Meier analysis and a Cox proportional hazards model were used to assess the treatment options and prognostic risk factors for UC. RESULTS Kaplan-Meier analysis showed no difference in the 5-year recurrence-free survival rate (P =0.282) or overall survival rate (P =0.673) between extended partial cystectomy (EPC) and radical cystectomy (RC) for patients at stage III and below. Whether bilateral pelvic lymph nodes were dissected was also not significantly correlated with the patient's recurrence (P =0.921) or prognosis (P =0.741). Postoperative adjuvant chemotherapy significantly reduced the recurrence rate of patients with stage Ⅲb or below (P =0.005). Combined treatment of postoperative recurrence patients prolonged the survival time of patients compared with single chemotherapy or conservative treatment (34.022±5.031 vs. 12.837±2.349 or 6.192±0.875 months, P <0.001). Kaplan-Meier and univariate Cox regression analyses showed that age >55 years, Sheldon stage, carbohydrate antigen 19-9 (CA19-9) >9.935 U/mL, carbohydrate antigen 72-4 (CA724) >6.02 U/mL, and postoperative adjuvant chemotherapy were closely related to the overall survival and recurrence-free survival of patients (P <0.05). Multivariate Cox proportional hazard regression confirmed that the Sheldon stage and CA724 >6.02 U/mL were independent recurrence risk factors. CONCLUSIONS EPC or RC provides similar oncologic results for UC, but bilateral pelvic lymph node dissection is not necessary in early-stage patients. Postoperative adjuvant chemotherapy can significantly reduce the recurrence rate, and combination therapy may provide better survival outcomes. CA724 can predict tumor recurrence or metastasis at an early stage.
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Affiliation(s)
- Chunjin Ke
- Department of Urology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Lu Xu
- Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Maoyu Wang
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yinzhao Wang
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Qian Zhou
- Department of Urology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Science, Jinan, China
| | - Jinchao Chen
- Department of Urology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
| | - Zhihua Wang
- Department of Urology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Zhiquan Hu
- Department of Urology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.
| | - Chunguang Yang
- Department of Urology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.
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Demographic profiles and survival outcomes of patients with urachal adenocarcinoma: a rare tumor of the urachal remnant. Clin Genitourin Cancer 2022. [DOI: 10.1016/j.clgc.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Das JP, Woo S, Ghafoor S, Andrieu PC, Ulaner GA, Donahue TF, Goh AC, Vargas HA. Value of MRI in evaluating urachal carcinoma: A single center retrospective study. Urol Oncol 2022; 40:345.e9-345.e17. [DOI: 10.1016/j.urolonc.2022.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/07/2022] [Accepted: 02/26/2022] [Indexed: 11/25/2022]
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7
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Dursun F, Lim K, Svatek RS, Xu J, El-Zaatari ZM, Wenker EP, Klaassen ZW, Mansour AM, Muhammad T, Efstathiou E, Sonpavde GP, Wallis CJD, Satkunasivam R. Clinical outcomes and patterns of population-based management of urachal carcinoma of the bladder: An analysis of the National Cancer Database. Cancer Med 2022; 11:4273-4282. [PMID: 35509235 DOI: 10.1002/cam4.4786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/24/2022] [Accepted: 04/08/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Given the low incidence of urachal carcinoma of the bladder (UCB), there is limited published data from contemporary population-based cohorts. This study aimed to describe demographic, clinicopathological features, and survival outcomes of patients diagnosed with UCB. METHODS The National Cancer Database (2004-2016) was queried for UCB patients. Descriptive analyses characterized demographics and clinicopathologic features. We assessed 5-year overall survival (OS) rates of the entire cohort and subgroups of localized/locally advanced and metastatic disease. We utilized Cox proportional hazards models to assess the association between covariates of interest and all-cause mortality and to examine the impact of surgical technique and chemotherapy. RESULTS We identified 841 patients with UCB. The most common histologic subtype was non-mucinous adenocarcinoma (39.6%). Approximately 50% had ≥cT2 disease, and 14.3% were metastatic at diagnosis. Altogether, partial cystectomy (60%) was most performed, and lymph node dissection was performed in 377 patients (44.8%), with specific temporal increase in utilization over the study period (p < 0.001). Overall, median OS was 59 months, and 5-year OS was 49%. In patients with localized/locally advanced disease, we found no association between partial and radical cystectomy (Hazards ratio [HR] 1.75; 95% CI 0.72-4.3) as well as receipt of perioperative chemotherapy (HR 1.97, 95% CI 0.79-4.90) and outcomes. Lastly, receipt of systemic therapy was not associated with survival benefit (HR 0.785, 95% CI 0.37-1.65) in metastatic disease cohort. CONCLUSION This large population-based cohort provides insight into the surgical management and systemic therapy, without clear evidence on the association of chemotherapy and survival in the perioperative and metastatic setting.
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Affiliation(s)
- Furkan Dursun
- Department of Urology, University of Texas Health San Antonio, San Antonio, Texas, USA.,Department of Urology, Houston Methodist Hospital, Houston, Texas, USA
| | - Kelvin Lim
- Department of Urology, Houston Methodist Hospital, Houston, Texas, USA
| | - Robert S Svatek
- Department of Urology, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Jiaqiong Xu
- Center for Outcomes Research, Houston Methodist Hospital, Houston, Texas, USA
| | - Ziad M El-Zaatari
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas, USA
| | - Evan P Wenker
- Department of Urology, Houston Methodist Hospital, Houston, Texas, USA
| | - Zachary W Klaassen
- Division of Urology, Medical College of Georgia-Augusta University, Augusta, Georgia, USA
| | - Ahmed M Mansour
- Department of Urology, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Taliah Muhammad
- Department of Urology, Houston Methodist Hospital, Houston, Texas, USA
| | - Eleni Efstathiou
- Department of Medical Oncology, Houston Methodist Hospital, Houston, Texas, USA
| | - Guru P Sonpavde
- Department of Genitourinary Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Christopher J D Wallis
- Department of Urology, University of Toronto, Toronto, Ontario, Canada.,Department of Urology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Raj Satkunasivam
- Department of Urology, Houston Methodist Hospital, Houston, Texas, USA.,Center for Outcomes Research, Houston Methodist Hospital, Houston, Texas, USA
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Zaleski MP, Chen H, Roy-Chowdhuri S, Patel KP, Luthra R, Routbort MJ, Kamat AM, Gao J, Siefker-Radtke A, Czerniak B, Guo CC. Distinct Gene Mutations Are Associated With Clinicopathologic Features in Urachal Carcinoma. Am J Clin Pathol 2022; 158:263-269. [PMID: 35467000 PMCID: PMC9350833 DOI: 10.1093/ajcp/aqac039] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 03/04/2022] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To investigate the gene mutational profile of urachal carcinoma in correlation with its clinicopathologic features. METHODS We analyzed genetic mutations in 30 cases of urachal carcinoma by next-generation sequencing (NGS) test. Histologic slides and clinical data were reviewed. RESULTS The patients included 21 men and 9 women, with a mean age of 53 years (range, 24-75 years). The urachal carcinomas included mucinous (11), enteric (10), signet ring cell (8), and high-grade neuroendocrine (1) subtypes. Targeted NGS analysis demonstrated genetic mutations in all the urachal tumors (mean, 2; range, 1-4). TP53 was the most mutated gene (25), followed by KRAS (9) and GNAS (8) genes. TP53 mutations were more common in the signet ring cell subtype (7/8), and GNAS mutations were present only in the mucinous (5/11) and signet ring cell subtypes (3/8) but not in the enteric subtype (0/10). KRAS mutations were significantly associated with cancer stage IV (P = .02) and younger patient age (P = .046). Furthermore, the presence of KRAS mutations in urachal carcinoma portended a poorer overall survival (P = .006). CONCLUSIONS Urachal carcinoma demonstrates frequent gene mutations that are associated with distinct clinicopathologic features. Gene mutation may underlie the development and progression of this aggressive disease.
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Affiliation(s)
- Michael P Zaleski
- Department Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hui Chen
- Department Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sinchita Roy-Chowdhuri
- Department Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Keyur P Patel
- Department Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rajyalakshmi Luthra
- Department Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mark J Routbort
- Department Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ashish M Kamat
- Department Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jianjun Gao
- Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Arlene Siefker-Radtke
- Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bogdan Czerniak
- Department Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Charles C Guo
- Department Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Xu Y, Guo Z, Peng H, Guo L, Wang P. IGF2BP3 promotes cell metastasis and is associated with poor patient survival in nasopharyngeal carcinoma. J Cell Mol Med 2022; 26:410-421. [PMID: 34894048 PMCID: PMC8743660 DOI: 10.1111/jcmm.17093] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 11/08/2021] [Accepted: 11/17/2021] [Indexed: 11/29/2022] Open
Abstract
Metastasis contributes to treatment failure in nasopharyngeal carcinoma (NPC) patients. Our study aimed at elucidating the role of insulin-like growth factor 2 mRNA binding protein 3 (IGF2BP3) in NPC metastasis and the underlying mechanism involved. IGF2BP3 expression in NPC was determined by bioinformatics, quantitative polymerase chain reaction and immunohistochemistry analyses. The biological function of IGF2BP3 was investigated by using in vitro and in vivo studies. In this study, IGF2BP3 mRNA and protein levels were elevated in NPC tissues. In addition, IGF2BP3 exerted an oncogenic role by promoting epithelial-mesenchymal transition (EMT), thereby inducing NPC cell migration and invasion. Further studies revealed that IGF2BP3 regulated the expression of key regulators of EMT by activating AKT/mTOR signalling, thus stimulating NPC cell migration and invasion. Remarkably, targeting IGF2BP3 delayed NPC metastasis through attenuating p-AKT and vimentin expression and inducing E-cadherin expression in vivo. Moreover, IGF2BP3 protein levels positively correlated with distant metastasis after initial treatment. Importantly, IGF2BP3 expression served as an independent prognostic factor in predicting the overall survival and distant metastasis-free survival of NPC patients. This work identifies IGF2BP3 as a novel prognostic marker and a new target for NPC treatment.
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Affiliation(s)
- Yun Xu
- Departments of Radiation OncologyTianjin Medical University Cancer Institute and HospitalNational Clinical Research Center for CancerKey Laboratory of Cancer Prevention and TherapyTianjin’s Clinical Research Center for CancerTianjinChina
- Fujian Medical University Cancer HospitalFujian Cancer HospitalFujianChina
| | - Zhoubo Guo
- Departments of Radiation OncologyTianjin Medical University Cancer Institute and HospitalNational Clinical Research Center for CancerKey Laboratory of Cancer Prevention and TherapyTianjin’s Clinical Research Center for CancerTianjinChina
| | - Hewei Peng
- Department of Epidemiology and Health StatisticsFujian Provincial Key Laboratory of Environment Factors and CancerSchool of Public HealthFujian Medical UniversityFuzhouChina
| | - Lanyan Guo
- School of Medical Technology and EngineeringFujian Medical UniversityFuzhouChina
| | - Ping Wang
- Departments of Radiation OncologyTianjin Medical University Cancer Institute and HospitalNational Clinical Research Center for CancerKey Laboratory of Cancer Prevention and TherapyTianjin’s Clinical Research Center for CancerTianjinChina
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Chen M, Xue C, Huang RQ, Ni MQ, Li L, Li HF, Yang W, Hu AQ, Zheng ZS, An X, Shi Y. Treatment Outcome of Different Chemotherapy in Patients With Relapsed or Metastatic Malignant Urachal Tumor. Front Oncol 2021; 11:739134. [PMID: 34604084 PMCID: PMC8479186 DOI: 10.3389/fonc.2021.739134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 08/20/2021] [Indexed: 01/10/2023] Open
Abstract
Background Malignant urachal tumor is a rare subtype of genitourinary cancer. Our aim was to explore the optimal chemotherapy regimens for relapsed or metastatic urachal carcinoma. Materials and Methods We retrospectively enrolled 24 adult patients with relapsed or metastatic urachal carcinoma from January 2014 to September 2020 at Sun Yat-sen University Cancer Center. We summarized the chemotherapy regimens and classified them as fluorouracil based, platinum based, and paclitaxel based. Nine patients received XELOX (capecitabine and oxaliplatin) regimens, seven patients received TX (paclitaxel and capecitabine) regimens, and eight of them received chemotherapy including GP (gemcitabine and cisplatin), TP (paclitaxel and cisplatin), TN (paclitaxel and nedaplatin), and tislelizumab. Results The disease control rate was 75%. Among all patients, one patient treated with XELOX achieved partial remission (PR), while 17 patients showed stable disease. The median progression-free survival (PFS) and overall survival (OS) in all treated patients was 7.43 and 29.7 months, respectively. The patients receiving first-line platinum-based chemotherapy presented better PFS than those without platinum (median PFS 8.23 vs. 3.80 months, p = 0.032), but not significant for OS between two groups. There is no significant difference in PFS and OS for fluorouracil-based and paclitaxel-based groups as first-line regimen. Next-generation gene sequencing revealed TP53 mutation and low tumor mutational burden in five out of seven cases. Conclusion The platinum-based chemotherapy regimen is effective for relapsed or metastatic urachal carcinoma.
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Affiliation(s)
- Meiting Chen
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Cong Xue
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ri-Qing Huang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Meng-Qian Ni
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Lu Li
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Hai-Feng Li
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Wei Yang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - An-Qi Hu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Zhou-San Zheng
- Department of Oncology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xin An
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yanxia Shi
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
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11
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Yu YD, Ko YH, Kim JW, Jung SI, Kang SH, Park J, Seo HK, Kim HJ, Jeong BC, Kim TH, Choi SY, Nam JK, Ku JY, Joo KJ, Jang WS, Yoon YE, Yun SJ, Hong SH, Oh JJ. The Prognosis and Oncological Predictor of Urachal Carcinoma of the Bladder: A Large Scale Multicenter Cohort Study Analyzed 203 Patients With Long Term Follow-Up. Front Oncol 2021; 11:683190. [PMID: 34136407 PMCID: PMC8202399 DOI: 10.3389/fonc.2021.683190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 05/04/2021] [Indexed: 01/24/2023] Open
Abstract
AIM This study evaluated the prognosis and survival predictors for bladder urachal carcinoma (UC), based on large scale multicenter cohort with long term follow-up database. METHODS A total 203 patients with bladder UC treated at 19 hospitals were enrolled. Clinical parameters on carcinoma presentation, diagnosis, and therapeutic methods were reviewed for the primary cancer and for all subsequent recurrences. The stage of UC was stratified by Mayo and Sheldon pathological staging system. Oncological outcomes and the possible clinicopathological parameters associated with survival outcomes were investigated. RESULTS The mean age of the patients was 54.2 years. Among the total of 203 patients, stages I, II, III, and IV (Mayo stage) were 48 (23.8%), 108 (53.5%), 23 (11.4%), and 23 (11.4%), respectively. Gross hematuria and bladder irritation symptoms were the two most common initial symptoms. The mean follow-up period was 65 months, and 5-year overall survival rates (OS), cancer-specific survival rates (CSS), and recurrence-free survival rates (RFS) were 88.3, 83.1, and 63.9%, respectively. For the patients with Mayo stage ≥III, OS, CSS, and RFS were significantly decreased to 38.0, 35.2, and 28.4%, respectively. The higher pathological stage (Mayo stage ≥III, Sheldon stage ≥IIIc), positive surgical margin (PSM), and positive lymphovascular invasion (PLM) were independent predictors of shorter OS, CSS, and RFS. CONCLUSION The pathological stage, PSM, and PLM were significantly associated with the survival of UC patients, emphasizing an importance of the complete surgical resection of tumor lesion.
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Affiliation(s)
- Young Dong Yu
- Department of Urology, College of Medicine, CHA University, Bundang CHA Hospital, Seongnam, South Korea
| | - Young Hwii Ko
- Department of Urology, Yeungnam University Hospital, Daegu, South Korea
| | - Jong Wook Kim
- Department of Urology, Korea University College of Medicine, Seoul, South Korea
| | - Seung Il Jung
- Department of Urology, Chonnam National University Medical School, Gwangju, South Korea
| | - Seok Ho Kang
- Department of Urology, Korea University School of Medicine, Seoul, South Korea
| | - Jinsung Park
- Department of Urology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, South Korea
| | - Ho Kyung Seo
- Department of Urology, Center for Urologic Cancer Hospital, Goyang, South Korea
| | - Hyung Joon Kim
- Department of Urology, Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon, South Korea
| | - Byong Chang Jeong
- Department of Urology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
| | - Tae-Hwan Kim
- Department of Urology, Kyungpook National University College of Medicine, Daegu, South Korea
| | - Se Young Choi
- Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Jong Kil Nam
- Department of Urology, Pusan National University Yangsan Hospital, Pusan, South Korea
| | - Ja Yoon Ku
- Department of Urology, Pusan National University Hospital, Busan, South Korea
| | - Kwan Joong Joo
- Department of Urology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, South Korea
| | - Won Sik Jang
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Eun Yoon
- Department of Urology, Hanyang University Hospital, Seoul, South Korea
| | - Seok Joong Yun
- Department of Urology, College of Medicine, Chungbuk National University, Chungbuk National University Hospital, Cheongju, South Korea
| | - Sung-Hoo Hong
- Department of Urology, Seoul St Mary’s Hospital, Seoul, South Korea
| | - Jong Jin Oh
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
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12
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Panic A, Reis H, Wittka A, Darr C, Hadaschik B, Jendrossek V, Klein D. The Biomarker Potential of Caveolin-1 in Penile Cancer. Front Oncol 2021; 11:606122. [PMID: 33868995 PMCID: PMC8045968 DOI: 10.3389/fonc.2021.606122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/12/2021] [Indexed: 01/11/2023] Open
Abstract
Various types of human cancers were characterized by an altered expression of epithelial or stromal caveolin-1 (CAV1). However, the clinical significance of CAV1 expression in penile cancer remains largely unknown. Here the expression patterns of CAV1 were analyzed in a retrospective cohort (n=43) of penile squamous cell carcinomas (SCC). Upon penile cancer progression, significantly increased CAV1-levels were determined within the malignant epithelium, whereas within the tumor stroma, namely the fibroblastic tumor compartment harboring activated and/or cancer associated fibroblasts, CAV1 levels significantly decline. Concerning the clinicopathological significance of CAV1 expression in penile cancer as well as respective epithelial-stromal CAV1 distributions, high expression within the tumor cells as well as low expression of CAV1 within the stromal compartment were correlated with decreased overall survival of penile cancer patients. Herein, CAV1 expressions and distributions at advanced penile cancer stages were independent of the immunohistochemically proven tumor protein p53 status. In contrast, less differentiated p16-positive tumor epithelia (indicative for human papilloma virus infection) were characterized by significantly decreased CAV1 levels. Conclusively, we provide further and new evidence that the characteristic shift in stromal‐epithelial CAV1 being functionally relevant to tumor progression even occurs in penile SCC.
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Affiliation(s)
- Andrej Panic
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Henning Reis
- Institute of Pathology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Alina Wittka
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, University Hospital, Essen, Germany
| | - Christopher Darr
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Boris Hadaschik
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Verena Jendrossek
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, University Hospital, Essen, Germany
| | - Diana Klein
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, University Hospital, Essen, Germany
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13
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Das JP, Vargas HA, Ulaner GA. Mucinous urachal adenocarcinoma: A potential nonfluorodeoxyglucose-avid pitfall on 18fluorine-fluorodeoxyglucose positron emission tomography/computed tomography. World J Nucl Med 2021; 19:432-434. [PMID: 33623517 PMCID: PMC7875043 DOI: 10.4103/wjnm.wjnm_60_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/25/2019] [Indexed: 11/08/2022] Open
Abstract
Mucinous adenocarcinoma of the urachal remnant is a nonurothelial malignancy that may be asymptomatic until locally advanced or metastatic. We describe a 37-year-old woman with invasive ductal breast carcinoma who underwent 18Fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) computed tomography (CT) demonstrating a non-FDG avid pelvic mass, initially suspected to represent a pedunculated uterine fibroid. Magnetic resonance imaging revealed a mixed solid-cystic mass separate from the uterus, suspicious for urachal neoplasm, confirmed as mucinous adenocarcinoma on histopathology. Urachal tumors may not be FDG-avid and represent a potential pitfall on FDG PET/CT.
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Affiliation(s)
- Jeeban Paul Das
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, USA.,Department of Radiology, Weill Cornell Medical College, New York, USA
| | - Hebert Alberto Vargas
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, USA.,Department of Radiology, Weill Cornell Medical College, New York, USA
| | - Gary A Ulaner
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, USA.,Department of Radiology, Weill Cornell Medical College, New York, USA
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14
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Jia Z, Chang X, Li X, Wang B, Zhang X. Urachal Carcinoma: Are Lymphadenectomy and Umbilectomy Necessary? Med Sci Monit 2020; 26:e927913. [PMID: 32958737 PMCID: PMC7519942 DOI: 10.12659/msm.927913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 09/08/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The aim of this study was to explore the impact of lymphadenectomy and umbilectomy on long-term survival and progression-free survival (PFS) of patients with urachal carcinoma. MATERIAL AND METHODS We performed a retrospective analysis of 39 patients with urachal carcinoma. Clinicopathologic outcomes were evaluated, and overall survival (OS) and PFS were assessed by Kaplan-Meier method and Cox regression analysis. RESULTS Thirty-four (87.2%) patients underwent partial cystectomy, and 3 (7.7%) patients underwent radical cystectomy with en bloc urachal resection. Eighteen (46.2%) patients underwent lymphadenectomy and 27 (69.2%) patients had umbilectomy. Multivariate analysis showed that tumor size (P=0.011), Mayo stage (P=0.012), and umbilectomy (P=0.007) were the independent prognostic factors for OS. The median overall survival time was 67 months. The differentiation degree of tumor (P=0.049), Mayo stage (P=0.004), and umbilectomy (P=0.046) were the independent prognostic factors for PFS. Lymph node resection was not a predictor of OS. Patients had poorer prognosis when the tumor invaded the entire wall, including the mucous layer, muscular layer, and serous layer of the bladder compared with those that invaded only the muscular layer (P=0.014). CONCLUSIONS Lymph node metastases and failure to undergo umbilectomy were the independent prognostic factors for OS and PFS. Lymph node resection was not a predictor of OS. Patients had poorer prognosis when the tumor invaded the entire wall of the bladder compared with those that invaded the muscular layer.
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15
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Das JP, Vargas HA, Ghafoor S, Goh AC, Ulaner GA. Clinical Utility of 18F-FDG PET/CT for Staging and Treatment Planning in Urachal Adenocarcinoma. J Nucl Med 2020; 62:643-647. [DOI: 10.2967/jnumed.120.251561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/11/2020] [Indexed: 01/01/2023] Open
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16
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Yu DD, Dong H, Wu ZG, Xiao YB, Zhou CF, Wang QQ, Cai J. U-shaped relationship of age at diagnosis and cancer-specific mortality in primary urachal adenocarcinoma: a cohort study. Transl Androl Urol 2020; 9:1073-1081. [PMID: 32676391 PMCID: PMC7354349 DOI: 10.21037/tau-19-863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND To examine the association between age at diagnosis and cancer-specific mortality (CSM) in primary urachal adenocarcinoma. METHODS The data was obtained from the National Cancer Institute's Surveillance, Epidemiology, and End Results program (SEER). A total of 393 patients were included in the study. Smooth curve fitting and two-piecewise Cox proportional hazards models were used to identify the nonlinearity between the age at initial diagnosis and cancer-specific survival rate. Survival time between different groups was compared using Kaplan-Meier survival curves and the log-rank test. RESULTS Using smooth curve fitting we found that the relationship between age at diagnosis and cancer-specific survival takes on a U-shaped curve. The inflection point that we identified for the age at initial diagnosis was 60 years. The log-likelihood ratio test (P<0.05) indicated that the two-piecewise Cox regression model was more appropriate for fitting the correlation of age at diagnosis and CSM. The two-piecewise Cox regression model showed that when the age was <60 years, reduced risk of CSM was significantly associated with increased age (HR: 0.95, P=0.0002). Conversely, when age was >60 years, increased risk of CSM was significantly associated with increased age (HR: 1.05, P=0.0499). CONCLUSIONS In summary, our study suggested that the relationship between age at diagnosis and cancer-specific survival is nonlinear, and takes on a U-shaped curve. Both younger and older age at initial diagnosis age were associated with increased CSM.
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Affiliation(s)
- Dong-Dong Yu
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Whenzhou, China
| | - Hui Dong
- Department of Respiratory Medicine, The First Affiliated Hospital of Wenzhou Medical University, Whenzhou, China
| | - Zhi-Gang Wu
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Whenzhou, China
| | - Yun-Bei Xiao
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Whenzhou, China
| | - Chao-Feng Zhou
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Whenzhou, China
| | - Qin-Quan Wang
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Whenzhou, China
| | - Jian Cai
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Whenzhou, China
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17
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Das JP, Vargas HA, Lee A, Hutchinson B, O'Connor E, Kok HK, Torreggiani W, Murphy J, Roche C, Bruzzi J, McCarthy P. The urachus revisited: multimodal imaging of benign & malignant urachal pathology. Br J Radiol 2020; 93:20190118. [PMID: 32045264 PMCID: PMC10993214 DOI: 10.1259/bjr.20190118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 11/17/2019] [Accepted: 02/10/2020] [Indexed: 01/02/2023] Open
Abstract
The urachus is a fibrous tube extending from the umbilicus to the anterosuperior bladder dome that usually obliterates at week 12 of gestation, becoming the median umbilical ligament. Urachal pathology occurs when there is incomplete obliteration of this channel during foetal development, resulting in the formation of a urachal cyst, patent urachus, urachal sinus or urachal diverticulum. Patients with persistent urachal remnants may be asymptomatic or present with lower abdominal or urinary tract symptoms and can develop complications. The purpose of this review is to describe imaging features of urachal remnant pathology and potential benign and malignant complications on ultrasound, CT, positron emission tomography CT and MRI.
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Affiliation(s)
- Jeeban Paul Das
- Dept. of Radiology, Galway University Hospital,
Co., Galway,
Ireland
- Dept. of Oncologic Imaging, Memorial Sloan Kettering Cancer
Centre, New York,
USA
- Dept. of Radiology, Beaumont Hospital,
Dublin 9, Ireland
| | | | - Aoife Lee
- Dept. of Radiology, Beaumont Hospital,
Dublin 9, Ireland
| | - Barry Hutchinson
- Dept. of Radiology, Galway University Hospital,
Co., Galway,
Ireland
| | - Eabhann O'Connor
- Dept. of Urology, St. Vincent's University
Hospital, Dublin,
Ireland
| | - Hong Kuan Kok
- Dept. of Radiology, Adelaide & Meath
Hospital, Dublin,
Ireland
| | | | - Joe Murphy
- Dept. of Radiology, Galway University Hospital,
Co., Galway,
Ireland
| | - Clare Roche
- Dept. of Radiology, Galway University Hospital,
Co., Galway,
Ireland
| | - John Bruzzi
- Dept. of Radiology, Galway University Hospital,
Co., Galway,
Ireland
| | - Peter McCarthy
- Dept. of Radiology, Galway University Hospital,
Co., Galway,
Ireland
- School of Medicine, Clinical Science Institute, National
University of Ireland, Galway,
Ireland
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18
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Duan F, Zhai W, Zhang B, Guo S. Urachal carcinoma: Impact of recurrence pattern and lymphadenectomy on long-term outcomes. Cancer Med 2020; 9:4166-4174. [PMID: 32329250 PMCID: PMC7300417 DOI: 10.1002/cam4.3059] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/25/2020] [Accepted: 03/27/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Urachal carcinoma is a rare nonurothelial malignant tumor with high rates of local recurrence and systemic metastasis. Although radical resection is widely considered the standard treatment, there is still a debate regarding the benefits of lymphadenectomy. To explore these factors, we investigated the recurrence pattern of urachal cancer and the impact of lymphadenectomy on long-term survival. METHODS The data of 62 patients pathologically diagnosed with urachal carcinoma at Sun Yat-sen University Cancer Center from 2002 to 2019 were retrospectively reviewed. Lymphadenectomy was defined as lymph nodes retrieved from the obturator, internal iliac, and external iliac lymph node stations. The Kaplan-Meier method and Cox regression model were used to identify prognostic factors. OS and DFS were the primary endpoints. RESULTS Of the 47 males and 15 females included, 54 patients underwent partial cystectomy, and 27 patients underwent lymphadenectomy. The number of patients with Sheldon stage IIIA, IIIB, IIIC, IVA, and IVB were 43 (69.4%), 4 (6.5%) 3 (4.8%), 6 (9.7%), and 6 (9.7%), respectively. The median DFS was 32.7 months, and the mean OS was 114.6 months. Sheldon stage (P < .001) and tumor size (P = .001) were identified as independent prognostic factors for DFS, whereas Sheldon stage (P = .003), peritoneal metastasis (P = .006), distant metastasis (P = .024), and recurrence in pelvic lymph nodes (P = .015) were independent prognostic factors for OS. CONCLUSIONS Urachal carcinoma has a high recurrence rate, but only peritoneal metastasis, distant metastasis, and recurrence in pelvic lymph nodes were found to be associated with OS. Lymphadenectomy was recommended because of its role in accurately staging the disease, and further research is needed to focus on lymphadenectomy and standardized the procedure.
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Affiliation(s)
- Fangfang Duan
- VIP Region, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Wenyu Zhai
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Bei Zhang
- VIP Region, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
| | - Shengjie Guo
- Department of Urology Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China
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19
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Abstract
PURPOSE OF REVIEW The aim of this review is to sum up the state of the art of urachal carcinoma (UC) in order to easily guide clinicians. RECENT FINDINGS UC is a rare and aggressive disease with consequent few data about diagnosis and treatment. Dates are mainly based on retrospective trial and case reports with limited prospective trial. Clinical presentation is not specific, often with urinary symptoms. Diagnosis is mainly based on CT scan and MRI, useful to evaluate local invasion and nodal status and to detect the presence of distant metastases. Therefore, biopsy is needed to obtain histological confirmation. Surgery is the gold standard for localized disease, while different chemotherapy schemes have been used in metastatic setting. Novel findings based on mutational analysis of the tumor include the use of biological treatment, such as cetuximab, and immunotherapy, such as atezolizumab, with satisfactory responses, suggesting that personalized treatment could be the most suitable option for UC.
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20
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Abstract
Urachal cancer is a rare but aggressive disease. In addition to the non-glandular tumors, non-cystic urachal adenocarcinomas are nowadays distinguished from the primary cystic variant. (Immunohistochemical) markers are only of minor differential diagnostic value and, therefore, the diagnosis is primarily established in a multidisciplinary approach. The non-cystic variant accounts for the majority of cases (83%), is more common in men (63%), shows a median age at diagnosis of 51 years and has a 5-year survival rate of about 50%. In organ-confined disease, usually a partial cystectomy of the tumor in the bladder dome, including the median umbilical ligament and umbilicus, is performed. In advanced stages, systemic therapy is needed while 5‑fuorouracil (5-FU) containing regimes have been shown to be more effective. Due to the rarity of the tumor, targeted therapy approaches based on a biological rationale are becoming increasingly relevant. As molecular data are still sparse, we compiled and analyzed the largest urachal cancer cohort to date. In 31% of the cases, MAPK-/PI3K signaling pathway alterations were detected (especially in K-/NRAS) with implications for anti-EGFR therapy approaches. Further potentially therapeutic alterations were detected in FGFR1, MET, PDGFRA, and erbB2/HER2. Additionally, PD-L1 tumor cell expression (clone: 22C3) was demonstrated in 16% of cases, therefore making anti-PD-1/PD-L1 immuno-oncological approaches worth considering despite the absence of mismatch repair deficiency (MMR-d) and/or high microsatellite instability (MSI-h). Finally, urachal adenocarcinomas seem to be a distinct entity on the molecular level with closer resemblance to colorectal adenocarcinomas than to urothelial carcinomas.
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Affiliation(s)
- H Reis
- Institute of Pathology, University Medicine Essen, West German Cancer Center Essen, University Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
| | - T Szarvas
- Clinic of Urology, University Medicine Essen, West German Cancer Center Essen, University Duisburg-Essen, Essen, Germany
- Clinic of Urology, Semmelweis University, Budapest, Hungary
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21
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Reis H, Szarvas T. [Urachal cancer - current concepts of a rare cancer (German version)]. DER PATHOLOGE 2018; 39:291-300. [PMID: 30470871 DOI: 10.1007/s00292-018-0498-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Urachal cancer is a rare but aggressive disease. In addition to the non-glandular tumors, non-cystic urachal adenocarcinomas are nowadays distinguished from the primary cystic variant. (Immunohistochemical) markers are only of minor differential diagnostic value and, therefore, the diagnosis is primarily established in a multidisciplinary approach. The non-cystic variant accounts for the majority of cases (83%), is more common in men (63%), shows a median age at diagnosis of 51 years and has a 5-year survival rate of about 50%. In organ-confined disease, usually a partial cystectomy of the tumor in the bladder dome, including the median umbilical ligament and umbilicus, is performed. In advanced stages, systemic therapy is needed while 5‑fuorouracil (5-FU) containing regimes have been shown to be more effective. Due to the rarity of the tumor, targeted therapy approaches based on a biological rationale are becoming increasingly relevant. As molecular data are still sparse, we compiled and analyzed the largest urachal cancer cohort to date. In 31% of the cases, MAPK-/PI3K signaling pathway alterations were detected (especially in K-/NRAS) with implications for anti-EGFR therapy approaches. Further potentially therapeutic alterations were detected in FGFR1, MET, PDGFRA, and erbB2/HER2. Additionally, PD-L1 tumor cell expression (clone: 22C3) was demonstrated in 16% of cases, therefore making anti-PD-1/PD-L1 immuno-oncological approaches worth considering despite the absence of mismatch repair deficiency (MMR-d) and/or high microsatellite instability (MSI-h). Finally, urachal adenocarcinomas seem to be a distinct entity on the molecular level with closer resemblance to colorectal adenocarcinomas than to urothelial carcinomas.
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Affiliation(s)
- H Reis
- Institut für Pathologie, Universitätsmedizin Essen, Westdeutsches Tumorzentrum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
| | - T Szarvas
- Klinik für Urologie, Universitätsmedizin Essen, Westdeutsches Tumorzentrum Essen, Universität Duisburg-Essen, Essen, Deutschland.,Klinik für Urologie, Semmelweis Universität, Budapest, Ungarn
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22
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Mercier F, Passot G, Villeneuve L, Levine EA, Yonemura Y, Goéré D, Sugarbaker PH, Marolho C, Bartlett DL, Glehen O. Peritoneal Carcinomatosis of Urachus Origin Treated by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): An International Registry of 36 Patients. Ann Surg Oncol 2018; 25:1094-1100. [PMID: 29238881 DOI: 10.1245/s10434-017-6299-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Indexed: 11/13/2023]
Abstract
PURPOSE Peritoneal carcinomatosis or pseudomyxoma peritonei from urachus is a rare form of presentation, often diagnosed at an advanced state of tumor burden. Because of its rarity, little is known about its natural history, prognosis, or optimal treatment. We searched a large international multicenter database of peritoneal surface disease to identify cases of peritoneal carcinomatosis of urachus that were treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) at expert centers. The aim is to improve knowledge and understanding of the disease and standardize its treatment. METHODS A prospective multicenter international database was retrospectively searched to identify all patients with urachus tumor and peritoneal metastases who underwent CRS and HIPEC through the Peritoneal Surface Oncology Group International (PSOGI). Postoperative complications, long-term results, and principal prognostic factors were analyzed. RESULTS The analysis included 36 patients. After median follow-up of 48 months, median overall survival (OS) was 58.5 months. Three- and 5-year OS was 55.4 and 46.2%, respectively. Patients who underwent complete macroscopic CRS had significantly better survival than those treated with incomplete CRS, with median OS not achieved and of 20.1 months, respectively [95% confidence interval (CI) 4.4-30.5, p < 0.001]. There were no postoperative deaths, and 37.9% of patients had major complications. CONCLUSION CRS and HIPEC may increase long-term survival in selected patients with peritoneal metastases of urachus origin, especially when complete CRS is achieved.
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Affiliation(s)
- Frederic Mercier
- Department of Surgical Oncology, CHU Lyon Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite, France
| | - Guillaume Passot
- Department of Surgical Oncology, CHU Lyon Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite, France
- EMR 37-38, Lyon 1 University, Lyon, France
| | - Laurent Villeneuve
- EMR 37-38, Lyon 1 University, Lyon, France
- Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon, France
| | - Edward A Levine
- Section of Surgical Oncology, Department of General Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Yutaka Yonemura
- Asian School of Peritoneal Surface Oncology, 510 Fukushima-Cho, Shimogyou-ku, Kyoto, Japan
- NPO to support Peritoneal Surface Malignancy Treatment, 510 Fukushima-Cho, Shimogyou-ku, Kyoto, Japan
- Regional Cancer Therapies, Peritoneal Surface Malignancy Center, Kishiwada Tokushukai Hospital, 4-27-1 Kamori-Cho, Kishiwada, Osaka, Japan
- Kutatsu General Hospital, 1660 Yabase-Cho, Kusatsu, Shiga, Japan
- Ikeda Hospital, 411-5 Honnjyuku, Nagaizumi-cho, Shizuoka, Japan
| | - Diane Goéré
- Department of Surgery, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Paul H Sugarbaker
- Center for Gastrointestinal Malignancies, Program in Peritoneal Surface Oncology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Christelle Marolho
- Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon, France
| | - David L Bartlett
- Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Olivier Glehen
- Department of Surgical Oncology, CHU Lyon Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite, France.
- EMR 37-38, Lyon 1 University, Lyon, France.
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23
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Reis H, Krafft U, Niedworok C, Módos O, Herold T, Behrendt M, Al-Ahmadie H, Hadaschik B, Nyirady P, Szarvas T. Biomarkers in Urachal Cancer and Adenocarcinomas in the Bladder: A Comprehensive Review Supplemented by Own Data. DISEASE MARKERS 2018; 2018:7308168. [PMID: 29721106 PMCID: PMC5867586 DOI: 10.1155/2018/7308168] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 02/06/2018] [Indexed: 12/11/2022]
Abstract
Urachal cancer (UrC) is a rare but aggressive cancer. Due to overlapping histomorphology, discrimination of urachal from primary bladder adenocarcinomas (PBAC) and adenocarcinomas secondarily involving the bladder (particularly colorectal adenocarcinomas, CRC) can be challenging. Therefore, we aimed to give an overview of helpful (immunohistochemical) biomarkers and clinicopathological factors in addition to survival analyses and included institutional data from 12 urachal adenocarcinomas. A PubMed search yielded 319 suitable studies since 1930 in the English literature with 1984 cases of UrC including 1834 adenocarcinomas (92%) and 150 nonadenocarcinomas (8%). UrC was more common in men (63%), showed a median age at diagnosis of 50.8 years and a median tumor size of 6.0 cm. No associations were noted for overall survival and progression-free survival (PFS) and clinicopathological factors beside a favorable PFS in male patients (p = 0.047). The immunohistochemical markers found to be potentially helpful in the differential diagnostic situation are AMACR and CK34βE12 (UrC versus CRC and PBAC), CK7, β-Catenin and CD15 (UrC and PBAC versus CRC), and CEA and GATA3 (UrC and CRC versus PBAC). Serum markers like CEA, CA19-9 and CA125 might additionally be useful in the follow-up and monitoring of UrC.
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Affiliation(s)
- Henning Reis
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147 Essen, Germany
| | - Ulrich Krafft
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147 Essen, Germany
| | - Christian Niedworok
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147 Essen, Germany
| | - Orsolya Módos
- Department of Urology, Semmelweis University, Üllői út 78/b, 1082 Budapest, Hungary
| | - Thomas Herold
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147 Essen, Germany
| | - Mark Behrendt
- Department of Urology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, Netherlands
| | - Hikmat Al-Ahmadie
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Boris Hadaschik
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147 Essen, Germany
| | - Peter Nyirady
- Department of Urology, Semmelweis University, Üllői út 78/b, 1082 Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr 55, 45147 Essen, Germany
- Department of Urology, Semmelweis University, Üllői út 78/b, 1082 Budapest, Hungary
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Thiem S, Herold T, Krafft U, Bremmer F, Tolkach Y, Szász AM, Kriegsmann J, Gaisa NT, Niedworok C, Szarvas T, Reis H. Telomerase reverse transcriptase (TERT) promoter mutations are rare in urachal cancer. Pathol Int 2017; 67:597-601. [PMID: 29047227 DOI: 10.1111/pin.12594] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 09/05/2017] [Indexed: 12/11/2022]
Abstract
High rates of telomerase reverse transcriptase (TERT) promoter mutations have recently been described in urothelial carcinoma (UC). Unlike UC in the bladder, adenocarcinomas account for the majority of urachal cancer (UrC) cases. As data in UrC is unclear, we analyzed TERT promoter mutations in a large cohort of UrC for its differential diagnostic, clinicopathological and prognostic significance. UrC cases from six academic centers were analyzed for c.-146C>T (C250T) and c.-124C>T (C228T) TERT promoter mutations by PCR and Sanger sequencing. Clinicopathological and survival data were collected. The cohort consisted of 15 men (56%) and 12 women (44%) with a median age of 50 years including 23 adenocarcinomas, two squamous cell carcinomas (SCC), one UC and one undifferentiated carcinoma. In one case of (mucinous) urachal adenocarcinoma a C228T mutation was detected (1/23; 4%), like in a case of SCC in addition to one C250T mutation in the UC case. TERT promoter mutations are very rare in urachal adenocarcinomas (unlike in UC) with differential diagnostic implications. Additionally, the low TERT promoter mutation rate in urachal adenocarcinomas is more comparable to colorectal adenocarcinomas than to UC, giving further support to recent genetic findings and therapeutic considerations.
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Affiliation(s)
- Sebastian Thiem
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Thomas Herold
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulrich Krafft
- Clinic of Urology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Felix Bremmer
- Institute of Pathology, University of Göttingen, Göttingen, Germany
| | - Yuri Tolkach
- Institute of Pathology, University of Bonn, Bonn, Germany
| | - Attila M Szász
- 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
| | - Joerg Kriegsmann
- Center for Histology, Cytology and Molecular Diagnostics Trier, Trier, Germany
| | - Nadine T Gaisa
- Institute of Pathology, RWTH Aachen University, Aachen, Germany
| | - Christian Niedworok
- Clinic of Urology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Tibor Szarvas
- Clinic of Urology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany.,Department of Urology, Semmelweis University, Budapest, Hungary
| | - Henning Reis
- Institute of Pathology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
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Chen L, Xie Y, Li X, Gu L, Gao Y, Tang L, Chen J, Zhang X. Prognostic value of high IMP3 expression in solid tumors: a meta-analysis. Onco Targets Ther 2017; 10:2849-2863. [PMID: 28652767 PMCID: PMC5476767 DOI: 10.2147/ott.s128810] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Accumulated studies have investigated the prognostic role of insulin-like growth factor II mRNA-binding protein 3 (IMP3) in various cancers, but inconsistent and controversial results were obtained. Therefore, we performed a systematic review and meta-analysis to investigate the potential value of IMP3 in the prognostic prediction of human solid tumors. MATERIALS AND METHODS A systematic literature search in the electronic databases PubMed, Embase, Web of Science, and Cochrane library (updated to April 2016) was conducted to identify eligible studies. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) for survival outcomes were calculated and gathered using STATA 12.0 software. RESULTS A total of 53 studies containing 8,937 patients with solid tumors were included in this meta-analysis. High IMP3 expression was significantly associated with worse overall survival (OS) of solid tumors (HR =2.08, 95% CI: 1.80-2.42, P<0.001). Similar results were observed in cancer-specific survival (CSS), disease-free survival (DFS), recurrence-free survival (RFS), progression-free survival (PFS), and metastasis-free survival (MFS). Further subgroup analysis stratified by tumor type showed that elevated IMP3 expression was associated with poor OS in renal cell carcinoma (RCC), lung cancer, oral cancer, urothelial carcinoma, hepatocellular carcinoma (HCC), colorectal cancer, pancreatic cancer, gastric cancer, and intrahepatic cholangiocarcinoma (ICC). CONCLUSION The current evidence suggests that high IMP3 expression is associated with poor prognosis in most solid tumors. IMP3 is a potential valuable prognostic factor and might serve as a promising biomarker to guide clinical decisions in human solid tumors.
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Affiliation(s)
- Luyao Chen
- Department of Urology, Chinese PLA General Hospital, Beijing.,Department of Urology, First Affiliated Hospital of Nanchang University, Nanchang
| | - Yongpeng Xie
- School of Medicine, Nankai University, Tianjin, People's Republic of China
| | - Xintao Li
- Department of Urology, Chinese PLA General Hospital, Beijing
| | - Liangyou Gu
- Department of Urology, Chinese PLA General Hospital, Beijing
| | - Yu Gao
- Department of Urology, Chinese PLA General Hospital, Beijing
| | - Lu Tang
- Department of Urology, Chinese PLA General Hospital, Beijing
| | - Jianwen Chen
- Department of Urology, Chinese PLA General Hospital, Beijing
| | - Xu Zhang
- Department of Urology, Chinese PLA General Hospital, Beijing
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Malignant urachal neoplasms: A population-based study and systematic review of literature. Urol Oncol 2017; 35:33.e11-33.e19. [DOI: 10.1016/j.urolonc.2016.07.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/29/2016] [Accepted: 07/29/2016] [Indexed: 01/16/2023]
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27
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Clinical, prognostic, and therapeutic aspects of urachal carcinoma—A comprehensive review with meta-analysis of 1,010 cases. Urol Oncol 2016; 34:388-98. [DOI: 10.1016/j.urolonc.2016.04.012] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 04/22/2016] [Accepted: 04/23/2016] [Indexed: 12/23/2022]
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