Survival benefit of chemotherapy in a contemporary cohort of metastatic urachal carcinoma

•Population-based analyses relying on the most contemporary SEER database.•Validation of the aggressive nature of metastatic urachal carcinoma (m-UraC).•m-UraC patients exposed to chemotherapy exhibited better survival.•These results were confirmed according to different survival endpoints (overall mortality and cancer-specific mortality).•Competing risks regression models and Propensity-score matching were used.•In sensitive analysis, survival benefit of chemotherapy was confirmed only in younger patients. We relied on the most contemporary Surveillance, Epidemiology, and End Results (SEER) database and tested the hypothesis that chemotherapy may improve survival in metastatic urachal carcinoma (m-UraC). Within the SEER database (2004–2016), we identified m-UraC patients aged ≥ 18 years. Propensity score matching (PSM: cystectomy status, age and sex), Kaplan-Meier plots, cumulative incidence plots, Cox regression models and competing risks regression (CRR) models addressed overall mortality (OM) and cancer-specific mortality (CSM). Overall, 274 m-UraC patients were identified with a median age of 70 years. Most were male (66%) and Caucasian (72%). Overall, 32% received chemotherapy. Chemotherapy-exposed patients were younger (62 vs. 73 years, p