Clin Genitourin Cancer. 2026 Jan 22:102509. doi: 10.1016/j.clgc.2026.102509. Online ahead of print.
ABSTRACT
BACKGROUND: Among patients with adenocarcinoma of the urinary bladder (ADKUB), prognostic analysis of urachal ADKUB is relatively limited, and there is no unified staging system. To investigate the impact of tumor location (urachal vs. nonurachal) on ADKUB, we evaluated the survival outcomes of urachal ADKUB and conducted a comparative analysis with nonurachal ADKUB after stage-stratified.
METHODS: We retrospectively collected clinicopathological and survival data from 82 patients with bladder adenocarcinoma treated at a single center, including 31 with urachal ADKUB and 51 with nonurachal ADKUB. To compare the survival outcomes with nonurachal ADKUB, a unified TNM staging system was first applied to urachal ADKUB. Subsequently, both cohorts were grouped into pT1-T2 and pT3-T4 categories for stage-stratified survival analysis.
RESULTS: Urachal ADKUB patients were younger and less likely to harbor comorbidities, with 24 patients (77.4%) receiving partial cystectomy and 7 patients (22.6%) receiving radical cystectomy. Urachal ADKUB was more likely to be Mucinous ADKUB (48.4% vs. 15.7%). The 5-year cancer-specific survival (CSS) and recurrence-free survival (RFS) were similar between the 2 groups (60.9% and 47.4% in urachal ADKUB vs. 52.2% and 40.7% in nonurachal ADKUB, respectively). When applying the unified TNM-based staging system, urachal ADKUB showed a possible trend toward better cancer-specific survival, which was more pronounced in patients with locally advanced and metastatic disease (pT3-T4 or higher; P = .048). On multivariate analysis, pathologic T stage (hazard ratio [HR], 4.721) and cardiovascular diseases (HR, 2.616) remained significantly associated with CSS in all patients. Poorly differentiated tumor (HR, 2.039) remained significantly associated with RFS.
CONCLUSIONS: Compared with nonurachal ADKUB, urachal ADKUB is relatively rare and shows a distinct histological distribution and clinicopathological features. Urachal ADKUB has a prognosis broadly comparable to nonurachal ADKUB, with a possible survival advantage in advanced disease that warrants further validation.
PMID:41692624 | DOI:10.1016/j.clgc.2026.102509