What is the role of partial cystectomy in the treatment of primary adenocarcinoma of the bladder?

Updated: Apr 03, 2019
  • Author: E Jason Abel, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Primary adenocarcinoma of the bladder may be treated with partial cystectomy in select cases. Urachal lesions, which represent 20-40% of all primary bladder adenocarcinomas, are thought to arise from residual transitional cells that line the urachal remnant in the dome of the bladder. Historically, the overall, 5-year survival rate associated with urachal adenocarcinoma has been poor (6-15%).

However, recent evidence has shown that extended partial cystectomy with removal of the bladder segment, posterior rectus fascia, peritoneum, and umbilicus offers the best chance for survival. In a study by Dandekar et al, the 5-year survival rate after partial cystectomy for urachal adenocarcinoma was 56.3%. [10] Herr found that contained urachal adenocarcinomas that were completely resected using extended partial cystectomy had a favorable disease-free rate (77%). [11] Following partial cystectomy, cure rates of well-differentiated urachal adenocarcinomas have been reported to approach 100%.


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