dc.contributor.author |
Szarvas, Tibor |
|
dc.contributor.author |
Módos, Orsolya |
|
dc.contributor.author |
Niedworok C |
|
dc.contributor.author |
Reis H |
|
dc.contributor.author |
Szendrői, Attila |
|
dc.contributor.author |
Szász, Attila Marcell |
|
dc.contributor.author |
Nyirády, Péter |
|
dc.date.accessioned |
2017-01-16T10:41:45Z |
|
dc.date.available |
2017-01-16T10:41:45Z |
|
dc.date.issued |
2016 |
|
dc.identifier |
84971658635 |
|
dc.identifier.citation |
pagination=388-398;
journalVolume=34;
journalIssueNumber=9;
journalTitle=UROLOGIC ONCOLOGY: SEMINARS AND ORIGINAL INVESTIGATIONS; |
|
dc.identifier.uri |
http://repo.lib.semmelweis.hu//handle/123456789/3893 |
|
dc.identifier.uri |
doi:10.1016/j.urolonc.2016.04.012 |
|
dc.description.abstract |
BACKGROUND AND OBJECTIVES: Urachal carcinoma (UrC) is a rare and poorly investigated disease. Our current knowledge is mainly based on single-institutional studies. Despite growing interest in UrC, the included case numbers in recently published studies are still low. Therefore, we aimed to provide a comprehensive meta-analysis on the clinical, prognostic, and therapeutic aspects of UrC. METHODS: A systematic Medline/PubMed search was performed on UrC using the terms "urachal carcinoma," "urachal cancer," and "urachus." Original articles and reviews in English language with case numbers>10 were selected. RESULTS: The vast majority (91%, 489/532) of UrCs are diagnosed at later stages (Sheldon>/=III) when the tumor invades the urinary bladder. About 21% (136/646) of UrC patients have distant metastasis at first presentation. Although for patients with non-metastatic UrC surgical treatment provides an acceptable disease control, the systemic treatment of patients with progressed/metastatic UrC-in lack of prospective clinical trials-are less well established. Comparing cisplatin-based and 5-FU-based therapies in 74 published UrC cases, we found the latter to be superior in terms of radiographic response rates (9% vs. 44%, P = 0.043), but the combination of these 2 therapies provided the lowest progression rate (14%) with a similarly high response rate (43%). CONCLUSIONS: Owing to the lack of evidence-based guidelines, the therapy of UrC remains challenging. Given the infrequency of UrC, large prospective studies comparing different systemic therapies can hardly be conducted. Our metadata indicates that 5-FU-containing chemotherapy regimens are more effective than cisplatin-based treatment modalities, whereas their combination seems to provide the strongest antitumor effect. Nevertheless, in the lack of evidences from prospective clinical trials, therapeutic decision-making necessarily remains on an individual basis. In this situation, targeted therapies may provide a reasonable alternative. Therefore, better understanding of the molecular background of UrC is needed to rationalize treatment decisions in UrC. |
|
dc.relation.ispartof |
urn:issn:1078-1439 |
|
dc.title |
Clinical, prognostic, and therapeutic aspects of urachal carcinoma-A comprehensive review with meta-analysis of 1,010 cases |
|
dc.type |
Journal Article |
|
dc.date.updated |
2016-11-29T12:38:13Z |
|
dc.language.rfc3066 |
en |
|
dc.identifier.mtmt |
3078318 |
|
dc.identifier.wos |
WOS:000382216400003 |
|
dc.identifier.pubmed |
27267737 |
|
dc.contributor.department |
SE/AOK/K/Urológiai Klinika |
|
dc.contributor.department |
SE/AOK/I/II. Sz. Patológiai Intézet |
|
dc.contributor.institution |
Semmelweis Egyetem |
|