Characterization and Outcomes of Small Cell Carcinoma of the Bladder using the Surveillance, Epidemiology and End Results Database

Successful treatment of recurrent small cell carcinoma of urinary bladder with pembrolizumab

“…In most cases, they initially present with gross hematuria and have muscle invasive stage T2 or higher at the time of diagnosis. 6,7 The standard treatment protocol is lacking and the prognosis of SCCB is poor, and 5-year survival rate of all comers are somewhere between 16 and 25%. 8,9 According to the 2019 National Comprehensive Cancer Network guidelines in bladder cancer, initial chemotherapy followed by radiotherapy or cystectomy is recommended for patients with SCCB with localized disease regardless of stage.…”

“…SCCB accounts for less than 1% of all the bladder cancers and predominantly occurs in men (3:1 male‐to‐female ratio) at the 6th decade of their lives. In most cases, they initially present with gross hematuria and have muscle invasive stage T2 or higher at the time of diagnosis 6,7 . The standard treatment protocol is lacking and the prognosis of SCCB is poor, and 5‐year survival rate of all comers are somewhere between 16 and 25% 8,9 …”

Editorial Comment from Dr Ismaili to Local control rate and prognosis after sequential chemoradiation for small cell carcinoma of the bladder

“…However, it is important to note that patients analyzed in these studies had poor outcomes (OS was 21 months and 17 months, respectively), and that these studies present several limitations: characteristics of treatment groups were not balanced, and details about treatments (chemotherapy and radiotherapy) were not analyzed. 5,6 In contrast, the authors suggested that prophylactic cranial irradiation (PCI) should not be used in SSCB. I do not agree with them.…”

“…Accumulating evidence suggests that resistance to cytotoxic therapies and metastatic processes share activation of common oncogenic pathways in cancer cells. 6 Targeting these oncogenic pathways would improve the therapeutic response to chemo-/radiotherapy, increase the chance of bladder preservation, reduce metastatic potential and eventually improve survival of patients with muscle-invasive bladder cancer.…”

“…The results of the recent studies based on the Surveillance, Epidemiology and End Results‐Medicare database (1988–2007), showed that cystectomy (with or without chemotherapy) and bladder‐sparing approaches using radiotherapy (with or without chemotherapy) are two equivalent strategies in the management of SCCB. However, it is important to note that patients analyzed in these studies had poor outcomes (OS was 21 months and 17 months, respectively), and that these studies present several limitations: characteristics of treatment groups were not balanced, and details about treatments (chemotherapy and radiotherapy) were not analyzed …”