The best course of treatment for urachal carcinoma is not clear because it is such an uncommon tumor. Patients with metastases are treated primarily with chemotherapy. Patients without metastases usually are treated with a partial cystectomy that includes removal of the tumor and bladder adjacent to the tumor along with the urachal ligament, including the umbilicus (navel). In addition to surgery, most patients are then treated with chemotherapy.
There is no current consensus as to the best type of chemotherapy, but urachal carcinoma seems to respond better to treatments aimed at colon cancer than it does to treatments traditionally used in bladder cancers. Approximately half of patients will achieve 5-year survival if they do not have metastases. Many patients with urachal carcinoma will be eligible for clinical trials.