Korean J Urol.  2014 Sep;55(9):574-580. 10.4111/kju.2014.55.9.574.

Prognostic Factors for Urachal Cancer: A Bayesian Model-Averaging Approach

• Kim IK
• Lee JY
• Kwon JK
• Park JJ
• Cho KS
• Ham WS
• Hong SJ
• Yang SC
• Choi YD

• KMID: 2069774
• DOI: http://doi.org/10.4111/kju.2014.55.9.574

Abstract

PURPOSE
This study was conducted to evaluate prognostic factors and cancer-specific survival (CSS) in a cohort of 41 patients with urachal carcinoma by use of a Bayesian model-averaging approach.
MATERIALS AND METHODS
Our cohort included 41 patients with urachal carcinoma who underwent extended partial cystectomy, total cystectomy, transurethral resection, chemotherapy, or radiotherapy at a single institute. All patients were classified by both the Sheldon and the Mayo staging systems according to histopathologic reports and preoperative radiologic findings. Kaplan-Meier survival curves and Cox proportional-hazards regression models were carried out to investigate prognostic factors, and a Bayesian model-averaging approach was performed to confirm the significance of each variable by using posterior probabilities.
RESULTS
The mean age of the patients was 49.88+/-13.80 years and the male-to-female ratio was 24:17. The median follow-up was 5.42 years (interquartile range, 2.8-8.4 years). Five- and 10-year CSS rates were 55.9% and 43.4%, respectively. Lower Sheldon (p=0.004) and Mayo (p<0.001) stage, mucinous adenocarcinoma (p=0.005), and larger tumor size (p=0.023) were significant predictors of high survival probability on the basis of a log-rank test. By use of the Bayesian model-averaging approach, higher Mayo stage and larger tumor size were significant predictors of cancer-specific mortality in urachal carcinoma.
CONCLUSIONS
The Mayo staging system might be more effective than the Sheldon staging system. In addition, the multivariate analyses suggested that tumor size may be a prognostic factor for urachal carcinoma.

Keyword

Follow-up studies; Survival; Urachal cancer

MeSH Terms

Adult
Bayes Theorem
Carcinoma/*pathology/*therapy
Disease-Free Survival
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Staging
Prognosis
Proportional Hazards Models
Risk Factors
Treatment Outcome
Urinary Bladder Neoplasms/*pathology/*therapy

Figure

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  FIG. 1 Cancer-specific survival (CSS) in 41 patients in the study cohort. Five- and 10-year CSS rates were 55.9% and 43.4%, respectively.

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  FIG. 2 (A) <55 y vs. ≥55 y; (B) Sheldon stage IIIA, IIIB, and IIIC vs. Sheldon stage IIID, IVA, and IVB; (C) Mayo stages I and II vs. Mayo stages III and IV; (D) mucinous adenocarcinoma vs. others; and (E) <5 cm vs. ≥5 cm.

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