Cancer Res Treat.  2023 Oct;55(4):1337-1345. 10.4143/crt.2023.417.

TNM-Based Head-to-Head Comparison of Urachal Carcinoma and Urothelial Bladder Cancer: Stage-Matched Analysis of a Large Multicenter National Cohort

  • 1Department of Urology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
  • 2Department of Urology, Seoul National University College of Medicine, Seoul, Korea
  • 3Department of Urology, Yeungnam University Hospital, Daegu, Korea
  • 4Department of Urology, Korea University College of Medicine, Seoul, Korea
  • 5Department of Urology, Chonnam National University Medical School, Gwangju, Korea
  • 6Department of Urology, Korea University School of Medicine, Seoul, Korea
  • 7Department of Urology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea
  • 8Department of Urology, Center for Urologic, National Cancer Center, Goyang, Korea
  • 9Department of Urology, Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon, Korea
  • 10Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 11Department of Urology, Kyungpook National University College of Medicine, Daegu, Korea
  • 12Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
  • 13Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea
  • 14Department of Urology, Dongnam Institute of Radiological & Medical Sciences, Busan, Korea
  • 15Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 16Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
  • 17Department of Urology, Hanyang University Hospital, Seoul, Korea
  • 18Department of Urology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
  • 19Department of Urology, Seoul St. Mary's Hospital, Seoul, Korea


Outcome analysis of urachal cancer (UraC) is limited due to the scarcity of cases and different staging methods compared to urothelial bladder cancer (UroBC). We attempted to assess survival outcomes of UraC and compare to UroBC after stage-matched analyses.
Materials and Methods
Total 203 UraC patients from a multicenter database and 373 UroBC patients in single institution from 2000 to 2018 were enrolled (median follow-up, 32 months). Sheldon stage conversion to corresponding TNM staging for UraC was conducted for head-to-head comparison to UroBC. Perioperative clinical variables and pathological results were recorded. Stage-matched analyses for survival by stage were conducted.
UraC patients were younger (mean age, 54 vs. 67 years; p < 0.001), with 163 patients (80.3%) receiving partial cystectomy and 23 patients (11.3%) radical cystectomy. UraC was more likely to harbor ≥ pT3a tumors (78.8% vs. 41.8%). While 5-year recurrence-free survival, cancer-specific survival (CSS) and overall survival were comparable between two groups (63.4%, 67%, and 62.1% in UraC and 61.5%, 75.9%, and 67.8% in UroBC, respectively), generally favorable prognosis for UraC in lower stages (pT1-2) but unfavorable outcomes in higher stages (pT4) compared to UroBC was observed, although only 5-year CSS in ≥ pT4 showed statistical significance (p=0.028). Body mass index (hazard ratio [HR], 0.929), diabetes mellitus (HR, 1.921), pathologic T category (HR, 3.846), and lymphovascular invasion (HR, 1.993) were predictors of CSS for all patients.
Despite differing histology, UraC has comparable prognosis to UroBC with relatively favorable outcome in low stages but worse prognosis in higher stages. The presented system may be useful for future grading and risk stratification of UraC.


Urinary bladder neoplasms; Urachal cancer; Cystectomy; Neoplasm staging; TNM classification; Survival analysis


  • Fig. 1 Recurrence-free survival (A), cancer-specific survival (B), and overall survival (C) comparison of urachal carcinoma (UraC) and urothelial bladder cancer (UroBC).

  • Fig. 2 Recurrence-free survival, cancer-specific survival, and overall survival comparison of urachal carcinoma (UraC) and urothelial bladder cancer (UroBC) stratified by matched TNM staging.



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