URACHAL CANCER - ROLE OF CONSERVATIVE SURGERY

被引:95
作者
HENLY, DR
FARROW, GM
ZINCKE, H
机构
[1] MAYO CLIN & MAYO FDN,DEPT UROL,ROCHESTER,MN 55905
[2] MAYO CLIN & MAYO FDN,DIV SURG PATHOL,ROCHESTER,MN 55905
关键词
D O I
10.1016/0090-4295(93)90526-G
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Urachal carcinoma is a rare neoplasm (0.22% of all bladder cancers) associated with a dismal prognosis. The obscure anatomic position of the tumor often minimizes early symptoms and precludes a timely diagnosis. The reported survival for urachal neoplasms has been inauspicious, and radical surgery (en bloc cystoprostatectomy and wide excision of the urachus and umbilicus) has been recommended as the primary treatment. To provide a rationale for the surgical management of this cancer, 38 patients with urachal carcinoma were reviewed, including 28 men and 10 women (2.8:1) (median age at diagnosis, 56 years; range, 28 to 88 years). The majority of the tumors were of high grade and stage at the time of diagnosis; they were exclusively DNA aneuploid in the 10 patients studied. Most patients had partial (segmental) cystectomy/umbilectomy (n = 30) or en bloc radical cystoprostatectomy/umbitectomy (n = 4) as their initial treatment; five-year overall survival of 43 percent and 50 percent revealed essentially comparable outcomes for the two surgical approaches. Thus, in the initial management of urachal carcinoma, umbilectomy with partial cystectomy may be considered in selected cases; this can enhance quality of life without necessarily influencing survival adversely. Rather, disease outcome seems more dependent on the adverse biologic potential of this usually DNA aneuploid tumor, necessitating the development of more innovative systemic treatment modalities.
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收藏
页码:635 / 639
页数:5
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