1
|
Wang C, An T, Ma X. Urachal adenocarcinoma in an adolescent boy: a case report. BMC Pediatr 2024; 24:554. [PMID: 39215255 PMCID: PMC11363642 DOI: 10.1186/s12887-024-05021-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Urachal carcinoma is an extremely rare malignant tumor originating from the urachus. Urachal adenocarcinoma has never been reported in patients under 20 years of age. In this case, we describe a 15-year-old patient with urachal adenocarcinoma and propose possible risk factors. CASE PRESENTATION The patient presented with hematuria for two months and dysuria for one month, and had a history of smoking and alcohol consumption for three years. Ultrasonography showed an irregular mass on the anterior wall of the bladder. Contrast-enhanced computed tomography revealed a pedicled soft tissue mass measuring 2.6×2.4 cm within the bladder, showing significant enhancement. Partial cystectomy was conducted, and a histopathological diagnosis of urachal adenocarcinoma (T2N0M0) was made. During eight months of follow-up, the patient remained asymptomatic with no evidence of recurrence. CONCLUSIONS Urachal remnants may lead to urinary symptoms and the development of urachal carcinoma. A history of smoking and alcohol consumption could be possible risk factors for urachal adenocarcinoma in this case. It is possible that urachal remnants can undergo malignant transformation, even at ages as young as 15 years. Regular follow-up should be recommended for patients whose urachal remnants persist beyond childhood.
Collapse
Affiliation(s)
- Chuan Wang
- Department of Pediatric Surgery, West China Hospital, Sichuan University, #37 Guo-Xue-Xiang, Chengdu, 610041, China
| | - Ting An
- Department of Pediatric Surgery, West China Hospital, Sichuan University, #37 Guo-Xue-Xiang, Chengdu, 610041, China
| | - Xue Ma
- Department of Pediatric Surgery, West China Hospital, Sichuan University, #37 Guo-Xue-Xiang, Chengdu, 610041, China.
| |
Collapse
|
2
|
Mai Y, Feng L, Liu Z, Nie Y, Jiang Z, Qin J. Urachus adenocarcinoma mistaken for umbilical incision implant cancer after laparoscopic cholecystectomy: a case report. Pathol Oncol Res 2023; 29:1611334. [PMID: 38188612 PMCID: PMC10766800 DOI: 10.3389/pore.2023.1611334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 12/11/2023] [Indexed: 01/09/2024]
Abstract
Umbilical incision implant cancer after LC is rare. Elective cholecystectomy was planned for a 49 years-old female patient with symptomatic gallstones. The patient underwent transumbilical single-port LC after admission to our hospital. Gallbladder specimens were obtained directly through the umbilical puncture hole, and histopathology suggested chronic cholecystitis. Three months after surgery, the patient experienced painful induration in the umbilicus. We initially considered incision scar hyperplasia complicated with pain, and used drugs to treat it conservatively without taking special treatment measures. Six months after LC, the umbilical induration pain affected her quality of life, and the patient requested surgical resection. Preoperative ultrasonography and abdominal computerized tomography (CT) revealed nodular changes around the umbilicus and no abdominal mass. Local resection of the periumbilical mass was performed, and the pathological confirmation was invasive adenocarcinoma. Subsequently, the patient underwent repeat periumbilical mass enlargement resection. Postoperative pathology showed no cancer at the enlarged resection margin, yet the umbilical center pathology showed invasive adenocarcinoma. The excised pathology was sent to the Sun Yat-sen University Cancer Center for consultation because of the rare nature of the findings associated with the case. After consultation, a diagnosis of umbilical urachus adenocarcinoma was confirmed based on pathological morphology, immunohistochemistry, and the specific anatomical location of the tumor. This case report shown that when there is a persistent mass induration in the navel after LC surgery, the possibility of incision tumor should be considered, rather than simply excluding the possibility of a cancer based on a non-cancer medical history.
Collapse
Affiliation(s)
- Yanxing Mai
- Department of Geriatrics, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Lei Feng
- Department of Hepatobiliary Surgery II, General Surgery Center, Guangdong Provincial Research Center for Artificial Organ and Tissue Engineering, Guangzhou Clinical Research and Transformation Center for Artificial Liver, Institute of Regenerative Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Zhenxi Liu
- Department of Pathology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yu Nie
- Department of Hepatobiliary Surgery II, General Surgery Center, Guangdong Provincial Research Center for Artificial Organ and Tissue Engineering, Guangzhou Clinical Research and Transformation Center for Artificial Liver, Institute of Regenerative Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zesheng Jiang
- Department of Hepatobiliary Surgery II, General Surgery Center, Guangdong Provincial Research Center for Artificial Organ and Tissue Engineering, Guangzhou Clinical Research and Transformation Center for Artificial Liver, Institute of Regenerative Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jiasheng Qin
- Department of Hepatobiliary Surgery II, General Surgery Center, Guangdong Provincial Research Center for Artificial Organ and Tissue Engineering, Guangzhou Clinical Research and Transformation Center for Artificial Liver, Institute of Regenerative Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| |
Collapse
|
3
|
Patel J, Villegas A. Urachal Adenocarcinoma: A Rare Primary Cancer Managed With FOLFOX Chemotherapy. Cureus 2023; 15:e43849. [PMID: 37736429 PMCID: PMC10510567 DOI: 10.7759/cureus.43849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2023] [Indexed: 09/23/2023] Open
Abstract
Urachal adenocarcinoma (UA) represents a rare subset of bladder tumors involving a urachal remnant. Incidental gross hematuria is often the only presenting symptom, with patients often presenting late in their course, thereby imparting an overall poor prognosis. Although there are prior case reports, there is little literature reported and no standardized treatment guidelines. We report a case of a middle-aged male who presented with incidental gross hematuria after a fall. Workup indicated the presence of a calcified bladder dome mass and pathology reported a primary urachal adenocarcinoma with pelvic nodal involvement. Patient underwent surgical resection and subsequent adjuvant, systemic chemotherapy regimen with leucovorin, fluorouracil, and oxaliplatin (FOLFOX). We hope to bring greater awareness to this rare cause of bladder malignancy.
Collapse
Affiliation(s)
- Jay Patel
- Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, USA
| | - Augusto Villegas
- Hematology and Oncology, Florida Cancer Specialists, Fleming Island, USA
| |
Collapse
|
4
|
Stokkel LE, van Rossum HH, van de Kamp MW, Boellaard TN, Bekers EM, Kok NFM, van Rhijn BWG, Mertens LS. Clinical value of preoperative serum tumor markers CEA, CA19-9, CA125, and CA15-3 in surgically treated urachal cancer. Urol Oncol 2023; 41:326.e17-326.e24. [PMID: 36813613 DOI: 10.1016/j.urolonc.2023.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/20/2022] [Accepted: 01/27/2023] [Indexed: 02/23/2023]
Abstract
INTRODUCTION Urachal adenocarcinoma (UrAC) is a very rare malignancy with a poor prognosis. The role of preoperative serum tumor markers (STMs) in UrAC is unknown. The aim of this study was to assess the clinical value of elevated STMs including carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9), cancer antigen 125 (CA125), and cancer antigen 15-3 (CA15-3) in surgically treated UrAC, and to evaluate their prognostic significance. METHODS This was a retrospective study of consecutive patients with histopathologically confirmed UrAC who underwent surgical treatment at a single tertiary hospital. Blood levels of CEA, CA19-9, CA125, and CA15-3 were determined before surgery. The proportion of patients with elevated STMs was calculated, as well as the association between elevated STMs and clinicopathological characteristics, recurrence-free survival and disease-specific survival. RESULTS Of the 50 patients included; CEA, CA 19-9, CA125, and CA15-3 were elevated in 40%, 25%, 26%, and 6% respectively. Elevated CEA was associated with higher pT-stage (odds ratio [OR] 3.3 [95% confidence interval 1.0-11.1], P = 0.003), higher Sheldon stage (OR 6.9 [95% CI 0.8-60.4], P = 0.01), male sex (OR 4.7 [95% CI 1.2-18.3], P = 0.01), and the presence of peritoneal metastases at the time of diagnosis (OR 3.5 [95% CI 0.9-14.2], P = 0.04). Elevated CA19-9 was associated with signet-cell component (OR 1.7 [95% CI 0.9-3.3], P = 0.03) and elevated CA125 was associated with peritoneal metastases at the time of diagnosis (OR 6.0 [95% CI 1.2-30.6], P = 0.04). Elevated STMs before surgery were not associated with recurrence-free survival and/or disease-specific survival. CONCLUSION A subset of patients with surgically treated UrAC has elevated STMs preoperatively. CEA was most frequently (40%) elevated and correlated with unfavorable tumor characteristics. However, STM levels did not correlate with prognostic outcomes.
Collapse
Affiliation(s)
- Laura E Stokkel
- Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Huub H van Rossum
- Department of Analytical Chemistry, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Maaike W van de Kamp
- Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Thierry N Boellaard
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Elise M Bekers
- Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Niels F M Kok
- Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Bas W G van Rhijn
- Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany
| | - Laura S Mertens
- Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| |
Collapse
|
5
|
Mohanty SK, Lobo A, Mishra SK, Cheng L. Precision Medicine in Bladder Cancer: Present Challenges and Future Directions. J Pers Med 2023; 13:jpm13050756. [PMID: 37240925 DOI: 10.3390/jpm13050756] [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: 03/08/2023] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
Bladder cancer (BC) is characterized by significant histopathologic and molecular heterogeneity. The discovery of molecular pathways and knowledge of cellular mechanisms have grown exponentially and may allow for better disease classification, prognostication, and development of novel and more efficacious noninvasive detection and surveillance strategies, as well as selection of therapeutic targets, which can be used in BC, particularly in a neoadjuvant or adjuvant setting. This article outlines recent advances in the molecular pathology of BC with a better understanding and deeper focus on the development and deployment of promising biomarkers and therapeutic avenues that may soon make a transition into the domain of precision medicine and clinical management for patients with BC.
Collapse
Affiliation(s)
- Sambit K Mohanty
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute and CORE Diagnostics, Gurgaon 122016, India
| | - Anandi Lobo
- Department of Pathology and Laboratory Medicine, Kapoor Center for Pathology and Urology, Raipur 490042, India
| | - Sourav K Mishra
- Department of Medical Oncology, All India Institute of Medical Sciences, Bhubaneswar 750017, India
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Brown University Warren Alpert Medical School, Lifespan Academic Medical Center, and the Legorreta Cancer Center at Brown University, 593 Eddy Street, APC 12-105, Providence, RI 02903, USA
| |
Collapse
|
6
|
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.
Collapse
|
7
|
Guerin M, Miran C, Colomba E, Cabart M, Herrmann T, Pericart S, Maillet D, Neuzillet Y, Deleuze A, Coquan E, Laramas M, Thibault C, Abbar B, Mesnard B, Borchiellini D, Dumont C, Boughalem E, Deville JL, Cancel M, Saldana C, Khalil A, Baciarello G, Flechon A, Walz J, Gravis G. Urachal carcinoma: a large retrospective multicentric study from the French Genito-Urinary Tumor Group. Front Oncol 2023; 13:1110003. [PMID: 36741023 PMCID: PMC9892758 DOI: 10.3389/fonc.2023.1110003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/06/2023] [Indexed: 01/20/2023] Open
Abstract
Introduction Urachal cancer (UrC) is a rare, non-urothelial malignancy. Its natural history and management are poorly understood. Although localized to the bladder dome, the most common histological subtype of UrC is adenocarcinoma. UrC develops from an embryonic remnant, and is frequently diagnosed in advanced stage with poor prognosis. The treatment is not standardized, and based only on case reports and small series. This large retrospective multicentric study was conducted by the French Genito-Urinary Tumor Group to gain a better understanding of UrC. Material and Methods data has been collected retrospectively on 97 patients treated at 22 French Cancer Centers between 1996 and 2020. Results The median follow-up was 59 months (range 44-96). The median age at diagnosis was 53 years (range 20-86), 45% were females and 23% had tobacco exposure. For patients with localized disease (Mayo I-II, n=46) and with lymph-node invasion (Mayo III, n=13) median progression-free-survival (mPFS) was 31 months (95% CI: 20-67) and 7 months (95% CI: 6-not reached (NR)), and median overall survival (mOS) was 73 months (95% CI: 57-NR) and 22 months (95% CI: 21-NR) respectively. For 45 patients with Mayo I-III had secondary metastatic progression, and 20 patients were metastatic at diagnosis. Metastatic localization was peritoneal for 54% of patients. Most patients with localized tumor were treated with partial cystectomy, with mPFS of 20 months (95% CI: 14-49), and only 12 patients received adjuvant therapy. Metastatic patients (Mayo IV) had a mOS of 23 months (95% CI: 19-33) and 69% received a platin-fluorouracil combination treatment. Conclusion UrC is a rare tumor of the bladder where patients are younger with a higher number of females, and a lower tobacco exposure than in standard urothelial carcinoma. For localized tumor, partial cystectomy is recommended. The mOS and mPFS were low, notably for patients with lymph node invasion. For metastatic patients the prognosis is poor and standard therapy is not well-defined. Further clinical and biological knowledge are needed.
Collapse
Affiliation(s)
- M. Guerin
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France,*Correspondence: M. Guerin,
| | - C. Miran
- Department of Medical Oncology, Centre Leon-Berard, Lyon, France
| | - E. Colomba
- Department of Cancer Medicine, Institut Gustave-Roussy, University of Paris Saclay, Villejuif, France
| | - M. Cabart
- Department of Medical Oncology, Institut Bergonie, Bordeaux, France
| | - T. Herrmann
- Department of Medical Oncology, Centre Jean-Perrin, Clermont-Ferrand, France
| | - S. Pericart
- Department of Anatomo-pathology, Institut Universitaire du Cancer, Centre Hospital-Universitaire de Toulouse, Toulouse, France
| | - D. Maillet
- Department of Medical Oncology, Centre hospitalo-Universitaire Hospices civils, Lyon, France
| | - Y. Neuzillet
- Department of Urology, Hopital Foch, Paris, France
| | - A. Deleuze
- Department of Medical Oncology, Centre Eugene Marquis, Rennes, France
| | - E. Coquan
- Department of Medical Oncology, Centre François Baclesse, Caen, France
| | - M. Laramas
- Department of Medical Oncology, Centre Hospitalo-Universitaire, Grenoble, France
| | - C. Thibault
- Department of Medical Oncology, Hopital Europeen Georges Pompidou, Paris, France
| | - B. Abbar
- Department of Medical Oncology, Hopital Pitié-Salpetriere, Paris, France
| | - B. Mesnard
- Department of Urology, Centre Hospitalo-Universitaire, Nantes, France
| | - D. Borchiellini
- Department of Medical Oncology, Centre Lacassagne, Nice, France
| | - C. Dumont
- Department of Medical Oncology, Hopital Saint-Louis, Paris, France
| | - E. Boughalem
- Department of Medical Oncology, Centre Paul Papin, Angers, France
| | - JL. Deville
- Department of Medical Oncology, Centre Hospitalo-Universitaire Timone, Marseille, France
| | - M. Cancel
- Department of Medical Oncology, Centre Hospitalo-Universitaire Bretonneau, Tours, France
| | - C. Saldana
- Department of Medical Oncology, Hopital Henri Mondor, Paris, France
| | - A. Khalil
- Department of Medical Oncology, Hopital tenon, Paris, France
| | - G. Baciarello
- Department of Cancer Medicine, Institut Gustave-Roussy, University of Paris Saclay, Villejuif, France
| | - A. Flechon
- Department of Medical Oncology, Centre Leon-Berard, Lyon, France
| | - J. Walz
- Department of Urology, Institut Paoli-Calmettes, Marseille, France
| | - G. Gravis
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| |
Collapse
|
8
|
Ding L, Xia B, Zhang Y, Liu Z, Wang J. Web-Based Prediction Models for Overall Survival and Cancer-Specific Survival of Patients With Primary Urachal Carcinoma: A Study Based on SEER Database. Front Public Health 2022; 10:870920. [PMID: 35719613 PMCID: PMC9201252 DOI: 10.3389/fpubh.2022.870920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/25/2022] [Indexed: 11/17/2022] Open
Abstract
Objective: We aimed to establish nomograms to predict the overall survival (OS) and cancer-specific survival (CSS) of patients with primary urachal carcinoma (UrC). Methods Information on patients diagnosed with UrC from 1975 to 2018 was collected from the Surveillance, Epidemiology, and End Results (SEER) Program Research Data. The independent prognostic factors were determined using univariate and multivariate Cox regression. Backward variable elimination according to the Akaike information criterion (AIC) identified the most accurate and parsimonious model. Nomograms were built based on regression coefficients. The C-index, calibration plot, Brier score, integrated discrimination improvement (IDI), area under the receiver operating curve (AUC), and decision curve analysis (DCA) curve were used to evaluate the efficiency of models. Results In total, 236 patients obtained from SEER were divided randomly into training and validation cohorts in a 70:30 ratio (166 and 70 patients, respectively). In the training cohort, multivariate Cox regression analysis indicated that pTNM/Sheldon/Mayo staging systems (included respectively), age, and tumor grade were independent prognostic factors for OS. A similar result was also found in CSS. While other variables, such as radiotherapy and chemotherapy, did not identify significant correlations. In predicting OS and CSS at 3- and 5- years, the nomograms based on pTNM showed superior discriminative and calibration capabilities in comparison to multiple statistical tools. The C-index values for the training cohort were 0.770 for OS and 0.806 for CSS, and similar outcomes were shown in further internal validation (C-index 0.693 for OS and 0.719 for CSS). We also discovered that the link between age at diagnosis and survival follows a U-shaped curve, indicating that the risk of poor prognosis decreases first and then increases with age. Conclusion The efficacy of pTNM in predicting the prognosis of patients with UrC was greater than that of the Sheldon and Mayo staging system. Therefore, we recommend pTNM as the preferred system to stage UrC. The novel constructed nomograms based on pTNM, age, and tumor grade showed high accuracy and specificity and could be applied clinically to predict the prognosis of patients with UrC.
Collapse
Affiliation(s)
- Li Ding
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Bin Xia
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Yang Zhang
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zijie Liu
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Junqi Wang
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| |
Collapse
|
9
|
Wang C, Wei J, Huang L, Xu C. Expression of 34 βE12 may be an independent predictor of survival in breast cancer. J Int Med Res 2021; 49:300060520967774. [PMID: 34666529 PMCID: PMC8532230 DOI: 10.1177/0300060520967774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objectives To investigate the relationship between high-molecular-weight cytokeratin (34βE12) and clinicopathological parameters (including HER-2, Ki67 and steroid receptors) in breast cancer to determine its usefulness as a prognostic marker. Methods In this retrospective study, the expression level 34βE12 was assessed in surgically resected breast cancer specimens by immunohistochemical staining. Data were correlated with the patients’ clinicopathological parameters. Results Of the 348 breast cancer tissue samples, 232 (67%) showed positive expression of 34βE12. There were statistically significant differences between the positive and negative 34βE12 expression groups in tumour size, lymph node involvement, oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2) status. There were no differences between groups in age, tumour grade, or Ki67 status. In addition, patients who were positive for 34βE12 had significantly extended overall survival. In multivariate analysis, the expression level of 34βE12 was found to be a significant independent prognostic factor. Conclusion These results suggest that positive 34βE12 expression is associated with a favourable outcome in breast cancer and so may be a useful prognostic factor. Further studies are required to confirm these results.
Collapse
Affiliation(s)
- Chuchu Wang
- Department of Breast and Thyroid Surgery, the First Affiliated Hospital of Shaoxing University, Shaoxing University Medical College, Zhejiang, China
| | - Jiangguo Wei
- Department of Pathology, the First Affiliated Hospital of Shaoxing University, Zhejiang, China
| | - Liming Huang
- Department of Breast and Thyroid Surgery, the First Affiliated Hospital of Shaoxing University, Shaoxing University Medical College, Zhejiang, China.,Department of Medical Research Centre, the First Affiliated Hospital of Shaoxing University, Zhejiang, China
| | - Chaoyang Xu
- Department of Breast and Thyroid Surgery, the First Affiliated Hospital of Shaoxing University, Shaoxing University Medical College, Zhejiang, China.,Department of Medical Research Centre, the First Affiliated Hospital of Shaoxing University, Zhejiang, China
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Yu X, Ma C, Wang M, Ying Y, Zhang Z, Ai X, Wang L, Zeng S, Xu C. Construction and Validation of Novel Prediction Tools Based on Large Population-Based Database to Predict the Prognosis of Urachal Cancer After Surgery. Front Oncol 2021; 11:718691. [PMID: 34595114 PMCID: PMC8476958 DOI: 10.3389/fonc.2021.718691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/13/2021] [Indexed: 11/27/2022] Open
Abstract
Background Urachal cancer is a rare neoplasm in the urological system. To our knowledge, no published study has explored to establish a model for predicting the prognosis of urachal cancer. The present study aims to develop and validate nomograms for predicting the prognosis of urachal cancer based on clinicopathological parameters. Methods Based on the data from the Surveillance, Epidemiology, and End Results database, 445 patients diagnosed with urachal cancer between 1975 and 2018 were identified as training and internal validation cohort; 84 patients diagnosed as urachal cancer from 2001 to 2020 in two medical centers were collected as external validation cohort. Nomograms were developed using a multivariate Cox proportional hazards regression analysis in the training cohort, and their performance was evaluated in terms of its discriminative ability, calibration, and clinical usefulness by statistical analysis. Results Three nomograms based on tumor–node–metastasis (TNM), Sheldon and Mayo staging system were developed for predicting cancer-specific survival (CSS) of urachal cancer; these nomograms all showed similar calibration and discrimination ability. Further internal (c-index 0.78) and external (c-index 0.81) validation suggested that Sheldon model had superior discrimination and calibration ability in predicting CSS than the other two models. Moreover, we found that the Sheldon model was able to successfully classify patients into different risk of mortality both in internal and external validation cohorts. Decision curve analysis proved that the nomogram was clinically useful and applicable. Conclusions The nomogram model with Sheldon staging system was recommended for predicting the prognosis of urachal cancer. The proposed nomograms have promising clinical applicability to help clinicians on individualized patient counseling, decision-making, and clinical trial designing.
Collapse
Affiliation(s)
- Xiaowen Yu
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China.,Department of Geriatrics, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Chong Ma
- Senior Department of Urology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Maoyu Wang
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yidie Ying
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Zhensheng Zhang
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Xing Ai
- Senior Department of Urology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Linhui Wang
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Shuxiong Zeng
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Chuanliang Xu
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| |
Collapse
|
12
|
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.
Collapse
|
13
|
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.
Collapse
|
14
|
Tejeda-Mariaca JE, Ordoñez-Alcantara M, Bello-Sedano A, Perez-Cornejo V, Grandez-Urbina JA. Case Report: Bladder adenocarcinoma: primary or urachal? F1000Res 2019; 8:1717. [PMID: 32832071 PMCID: PMC7416577 DOI: 10.12688/f1000research.20106.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Bladder adenocarcinoma (AC) is a scarce histological variant and there are few studies on its proper management. No previous case reports present the management of a urachal tumor and the incidental finding of bladder adenocarcinoma. Clinical case: We present the case of a young woman with nonspecific symptoms, who presented with a prior history of dysuria, bladder tenesmus, suprapubic pain and urinary urgency for one year, which had been treated as recurrent urinary tract infection. A partial cystectomy plus extended lymphadenectomy was scheduled. We found a bladder tumor with characteristics of a urachal tumor and the pathological report indicated a primary bladder AC. The patient had a complete recovery at one year of follow-up. Conclusions: A patient can present with a tumor with urachal characteristics; however, the pathology report can show primary AC. The decision to perform partial cystectomy was an appropriate option for the location of this tumor, with optimal surgical results. Still, a long-term follow-up is necessary. More specific management guidelines are required for the treatment of AC.
Collapse
Affiliation(s)
- J Eduardo Tejeda-Mariaca
- Urology Deparment, Hospital Nacional Alberto Sabogal Sologuren, Callao, 07001, Peru.,Uroscience Research Group, Lima, 15046, Peru.,Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Marco Ordoñez-Alcantara
- Urology Deparment, Hospital Nacional Alberto Sabogal Sologuren, Callao, 07001, Peru.,Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Aldo Bello-Sedano
- Urology Deparment, Hospital Nacional Alberto Sabogal Sologuren, Callao, 07001, Peru.,Biomedical Research Institute, Universidad Ricardo Palma, Santiago de Surco, Lima, 15039, Peru
| | - Victor Perez-Cornejo
- Urology Deparment, Hospital Nacional Alberto Sabogal Sologuren, Callao, 07001, Peru.,Biomedical Research Institute, Universidad Ricardo Palma, Santiago de Surco, Lima, 15039, Peru
| | | |
Collapse
|
15
|
Takahara K, Mochizuki Y, Ichimura S, Kurebayashi Y, Fujii K. Brain metastasis from urachal carcinoma. Surg Neurol Int 2019; 10:152. [PMID: 31528487 PMCID: PMC6744782 DOI: 10.25259/sni_79_2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 06/28/2019] [Indexed: 11/04/2022] Open
Abstract
Background Urachal carcinoma (UC) is a rare variant of bladder carcinoma. Only seven cases of brain metastasis from UC have been reported in the literature thus far. Case Description A 77-year-old female was diagnosed with a brain tumor in her left cerebellum 2 years after she underwent surgery for a primary UC in the bladder. Surgery was performed via a midline suboccipital approach and the tumor was totally removed. The excised lesion was pathologically diagnosed as a metastasis and displayed typical pathological features of urachal adenocarcinoma with abundant mucin mixed with signet ring cells. A recurrence was observed at the site of tumor removal 6 months after surgery, and then, gamma knife radiotherapy was performed to the lesion. Conclusion According to the five previously reported similar cases and our case, tumor removal is the treatment of choice. Routine whole brain radiotherapy is not the best treatment choice; however, local radiotherapy including conventional local radiotherapy or gamma knife radiotherapy could be implemented instead.
Collapse
Affiliation(s)
- Kento Takahara
- Department of Neurosurgery, Shizuoka City Shimizu Hospital, Shizuoka
| | - Yoichi Mochizuki
- Department of Neurosurgery, Shizuoka City Shimizu Hospital, Shizuoka
| | - Shinya Ichimura
- Department of Neurosurgery, Shizuoka City Shimizu Hospital, Shizuoka
| | - Yutaka Kurebayashi
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Koji Fujii
- Department of Neurosurgery, Shizuoka City Shimizu Hospital, Shizuoka
| |
Collapse
|
16
|
Mertens LS, Behrendt MA, Mehta AM, Stokkel L, de Jong J, Boot H, Horenblas S, van der Heijden MS, Moonen LM, Aalbers AG, Meinhardt W, van Rhijn BW. Long-term survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with peritoneal metastases of urachal cancer. Eur J Surg Oncol 2019; 45:1740-1744. [DOI: 10.1016/j.ejso.2019.03.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/14/2019] [Accepted: 03/26/2019] [Indexed: 11/24/2022] Open
|
17
|
Hamilou Z, North S, Canil C, Wood L, Hotte S, Sridhar SS, Soulières D, Latour M, Taussky D, Kassouf W, Blais N. Management of urachal cancer: A consensus statement by the Canadian Urological Association and Genitourinary Medical Oncologists of Canada. Can Urol Assoc J 2019; 14:E57-E64. [PMID: 31348743 DOI: 10.5489/cuaj.5946] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Zineb Hamilou
- Division of Oncology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Scott North
- Division of Medical Oncology, University of Alberta Cross Cancer Institute, Edmonton, AB, Canada
| | - Christina Canil
- Division of Medical Oncology, University of Ottawa, Ottawa, ON, Canada
| | - Lori Wood
- Division of Medical Oncology, Dalhousie University, Halifax, NS, Canada
| | - Sebastien Hotte
- Division of Medical Oncology, McMaster University, Hamilton, ON, Canada
| | - Srikala S Sridhar
- Division of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Denis Soulières
- Division of Oncology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Mathieu Latour
- Department of Pathology and Cellular Biology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Daniel Taussky
- Departement of Radiology, Radio-oncology and Nuclear Medicine, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Wassim Kassouf
- Division of Urology, McGill University Health Centre, Montreal, QC, Canada
| | - Normand Blais
- Division of Oncology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| |
Collapse
|
18
|
Urachal carcinoma: from gross specimen to morphologic, immunohistochemical, and molecular analysis. Virchows Arch 2018; 474:13-20. [PMID: 30302546 DOI: 10.1007/s00428-018-2467-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 09/23/2018] [Accepted: 09/30/2018] [Indexed: 12/26/2022]
Abstract
Urachal carcinoma (UrC) is an exceedingly rare neoplasm that develops from the urachus, an embryologic remnant of the urogenital sinus and allantois. The most commonly encountered histologic subtype is adenocarcinoma. The aim of this study is to characterize a series of UrC by morphology, immunohistochemistry, and molecular analysis. We retrospectively investigated seven cases of UrCs and assessed patient symptoms, imaging, histologic features, immunohistochemical profile, molecular characteristics, pathologic stages, and type of treatment. Immunostaining for CK7, CK20, Muc-2, CDX2, GATA3, β-catenin, and CK34βE12 was carried out on each neoplasm and on seven non-neoplastic urachal remnants as the control group. Additionally, a mutational analysis was performed using the QIAact Actionable Insights Tumor Panel Kit, which analyzes KRAS, NRAS, KIT, BRAF, PDGFRA, ALK, EGFR, ERBB2, PIK3CA, ERBB3, ESR1, and RAF1. Our cohort comprised five females and two males with a mean age of 64 years. UrCs consisted of two mucinous cystadenocarcinomas and five invasive, non-cystic adenocarcinomas. Carcinoma antigen expression profile was positive for CK20 and negative for CK34βE12 and GATA3 in all cases. Five of seven cases stained positively for Muc-2 and CDX2. On the contrary, non-neoplastic urachal remnants were immunoreactive for CK34βE12, CK7, and GATA3. Mutational analysis gave a positive result in four out of seven (57.1%) cases. All four positive tumors showed RAS mutation and one an additional mutation in PIK3CA. Urachal tumors exhibit peculiar morphologic, immunohistochemical, and molecular features. Due to the advanced stage at presentation, individualized treatment should be undertaken.
Collapse
|