Urachal Carcinoma: Insights from a National Database

Urachal carcinoma (UrC) is a rare malignancy often diagnosed at an advanced stage. In this study of 2,475 UrC patients, 50.34% had localized disease. Radical cystectomy patients were older (66.74 f 8.13 years) compared to partial cystectomy patients (60.55 f 12.92 years) ( P < .001). There is a trend towards partial cystectomy for localized UrC. Further research is needed to personalize surgery and improve outcomes. Introduction: Urachal carcinoma (UrC) is a rare, nonurothelial malignancy, comprising less than 1% of all bladder cancers. It usually affects males in their fifth to sixth decade and is often diagnosed at an advanced stage with metastasis. This study examines UrC population characteristics and management. Methods: We identified UrC patients from bladder biopsies or TURB in the Pear lDiver Mar iner database (2010-2022). Descr iptive statistics detailed patient characteristics. Student's T-Tests compared ages for partial vs. radical cystectomy, and Fisher's exact test compared SDOH presence. Significance was set at P < .05. Analyses used R version 3.6.0 within PearlDiver's software. Results: Among 2475 UrC patients (mean age 69.2 f 9.2 years, 73.1% men), most were in the south (36.5%), outpatient settings (84.5%), and privately insured (65.3%). A total of 418 (16.2%) had at least 1 SDOH. Imaging before diagnosis was used in 65.74% of patients, pr imar ily ultrasound. Smoking was present in 54.5%, diabetes in 42.9%, and obesity in 25.2%. After diagnosis, 1246 (50.34%) had localized disease; 407 underwent radical cystectomy and 330 partial cystectomy. Patients undergoing radical cystectomy were older (66.74 +/- 8.13 years) compared to those undergoing partial cystectomy (60.55 +/- 12.92 years) ( P < .001), with SDOH factors more prevalent in the partial cystectomy group ( P = .03). Conclusion: UrC is a rare, often advanced-stage cancer predominantly affecting older men. Our study shows a trend towards partial cystectomy for localized UrC. Further research is needed to personalize surgery and integrate multidisciplinary approaches for better outcomes.