Diagnosis And Treatment Analysis Of Urachal Carcinoma(With Literature Review)

Objective:To reveal the clinical features、diagnosis and treatment of urachal carcinoma and improve its treatment.Methods:Thirteen cases of urachal carcinoma treated from October2002to December2011at Shan Dong Province hospital of Shan Dong University were retrospectively reviewed and analyzed.Results:There were11cases of male and2cases of female,mean age48years; Periodical and painless gross hematuria, urgency and frequency of urination and mucus in urine were the common clinical manifestations in these patients, patients. CT scanning showed the diameter of carcinoma was between3-7cm,1patients involved in pelvic cavity metastasis and1involved in lung metastasis. Sheldon stages:Ⅱ1case,ⅢA8cases,ⅢC2cases, IVA1cases, IVB1cases. Ten patients underwent extensive partial excision of the bladder, among which one case developed distant metastasis and local recurrence,and died in12months;one patients developed local recurrence in two years and received chemotherapy with MVAC regimen,but had no response,and died in the next6months, while the other eight cases were followed up for3-120months,with a median follow-up of48months without recurrence.The patients with lung metastasis received chemotherapy with GC regimen, but had no response.Three patients underwent radical bladder resection and urinary diversion, two died from surgical complications3months and6months after operation,the other one was followed up for48months respectively without recurrence. The1-year and5-year survival rates of all cases were83.1%and25%.Conclusion:1.Extensive partial cystectomy might be the first choice of treatmend for the disease, Radical removal of the tumor during the first treatment and comprehensive therapies for advanced cancer patients and patients with recurrence or metastasis after operation are critical to improve the treatment efficacy of urachal carcinoma.2.In the perioperative period,we should complete the examination,if the patients achieved distant metastasis,we should make the relevant treatment;CT,MRI and cystoscope biopsy has the most significance for the diagnosis.3. Chemotherapy regimens used to treat advanced bladder cancer, including gemcitabine+cisplatin(GC) or methotrexate+vinblastine+doxorubicin+cisplatin (MVAC), have shown a poor responses in urachal cancers.4. Most of the patients were diagnosed at late stage and had relatively poor prognosis, Assess the treatment effect of the patients in time and have a careful follow-up is the important means to improve the survival rate.