Surgical Management of Urachal Cancer in Germany: A Nationwide Analysis From 2006 to 2022.

Abstract

Urachal cancer is a rare but highly aggressive malignancy. This study examined current trends in the surgical management of urachal cancer in Germany. 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. 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%. 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.