OBJECTIVE: Urachal cancer is a rare but highly aggressive malignancy. This study examined current trends in the surgical management of urachal cancer in Germany. MATERIAL & METHODS: The nationwide German hospital billing database (Destatis) and German quality reports were analyzed from 2006 to 2022. Identification of trends over time was performed using linear regression models. RESULTS: Between 2006 and 2022, a total of 2593 cases were treated for urachal cancer in Germany. In 530 cases, a partial (n = 413) or radical (n = 117) cystectomy was performed. The share of partial cystectomy for treatment of urachal cancer increased from 52% in 2006 to 74% in 2022 (p<0.001). Radical cystectomy decreased from 48% in 2006 to 26% in 2022. Robotic-assisted partial cystectomy increased slightly from 9.7% in 2019 to 10.5% in 2022. The median age of patients undergoing partial cystectomy for urachal cancer increased from 57 ± 15.35 years in 2006 to 62 ± 12.59 years in 2022 (p<0.001). Median length of stay after open partial cystectomy decreased from 14 days in 2006 to 9 days in 2022 (p<0.001). Median length of stay for robotic-assisted partial cystectomy was 7 days in 2022. The mortality rate following partial cystectomy was 0.753%. The most common in-hospital complications associated with urachal cancer were hematuria in 1.19%, severe hemorrhage and hematoma in 0.96%, and paralytic ileus in 0.61%. CONCLUSION: This study demonstrates an increasing trend toward the use of partial cystectomy in the treatment of urachal cancer, along with a trend toward shorter hospital stays in recent years.
Flegar et al. (Mon,) studied this question.