Small Cell Carcinoma of the Urinary Bladder Treated with Chemotherapy and Radiotherapy: Results in Five Cases

Bastús, R.; Caballero, Javier Martínez; González, Graciela Nogueras; Borrat, P.; Casalots, J; Segura, G. Gómez de; Martí, L I; Ristol, J; Cirera, Luis

doi:10.1159/000019870

Cited by 53 publications

(10 citation statements)

References 15 publications

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“…Similar findings were observed in three others larges series [5,8,11]. As for bladder TCC, the TNM-staging system was commonly used for SCCB [2,3,5-8,14,12,32,33]. Patients with SCCB restricted to the bladder, should be considered as having surgically resectable disease (≤T1-4aN0M0) [33].…”

Section: Reviewsupporting

confidence: 69%

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A rare bladder cancer - small cell carcinoma: review and update

Ismaili¹

2011

Orphanet J Rare Dis

107

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Small cell carcinoma of the bladder (SCCB) is rare, highly aggressive and diagnosed mainly at advanced stages. Hematuria is the main symptom of this malignancy. The origin of the disease is unknown; however the multipotent stem cell theory applies best to this case. Histology and immunohistochemistry shows a tumour which is indistinguishable from small cell lung carcinoma (SCLC). Coexistence of SCCB with other types of carcinoma is common. The staging system used is the TNM-staging of bladder transitional cell carcinoma. The treatment is extrapolated from that of SCLC. However, many patients with SCCB undergo radical resection which is rarely performed in SCLC. Patients with surgically resectable disease (< or = cT1-4aN0M0) should be managed with multimodal therapy associating chemotherapy, surgery and/or radiotherapy. Neoadjuvant chemotherapy using four chemotherapy cycles followed by radical cystectomy is the most effective therapeutic sequence. Patients with unresectable disease (> or = cT4bN+M+) should be managed with palliative chemotherapy based on neuroendocrine type regimens comprising a platinum drug (cisplatin in fit patients). The prognosis of the disease is poor mainly in the case of pure small cell carcinoma. Other research programs are needed to improve the outcome of SCCB.

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Section: Reviewsupporting

confidence: 69%

“…In analogy to SCLC, RT either alone or in combination with CT, was used to treat SCCB at localised disease [3,4,10,15,32]. …”

Section: Reviewmentioning

confidence: 99%

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A rare bladder cancer - small cell carcinoma: review and update

Ismaili¹

2011

Orphanet J Rare Dis

107

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“…Other features show no prognostic implications. In spite of the statistical nonsignificance of systemic chemotherapy in our series, it must be remembered that the best prognosis found in the literature was for patients receiving some cis –platinum–based chemotherapy [39, 40]. …”

Section: Discussionmentioning

confidence: 96%

Small Cell Carcinoma of the Urinary Bladder

Trias¹,

Algaba²,

Condom³

et al. 2001

Eur Urol

113

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“…Given the similarities between SCUC and its counterpart in the lungs, where chemoradiation remains a standard in limited-stage disease, others have advocated for chemoradiation [10,11]. There is no consensus regarding whether radiation or surgery is the optimal method of local consolidation.…”

Section: Discussionmentioning

confidence: 99%

Neoadjuvant Chemotherapy in Small Cell Urothelial Cancer Improves Pathologic Downstaging and Long-term Outcomes: Results from a Retrospective Study at the MD Anderson Cancer Center

et al. 2013

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Background Small cell urothelial carcinoma (SCUC) is a rare, aggressive malignancy with a propensity for early microscopic metastases. Data suggest that neoadjuvant chemotherapy may lead to improved survival compared with initial surgery. Objective To determine the influence of neoadjuvant chemotherapy on survival of SCUC patients in a large single-institution cohort. Design, setting, and participants Between 1985 and 2010, 172 patients were treated for SCUC at MD Anderson Cancer Center (MDACC). Clinical, pathologic, and surgical data were collected and analyzed. Outcome measurements and statistical analysis Overall survival (OS) and disease-specific survival (DSS) were calculated using the Kaplan-Meier method. Multivariable Cox proportional hazards models were used to evaluate the effects of neoadjuvant chemotherapy on survival. Results and limitations Of 125 patients with resectable disease (≤cT4aN0M0), 95 were surgical candidates. Forty-eight received neoadjuvant chemotherapy, and 47 underwent initial surgery. Neoadjuvant treatment was associated with improved OS and DSS compared with initial cystectomy (median OS: 159.5 mo vs 18.3 mo, p < 0.001; 5-yr DSS: 79% vs 20%, p < 0.001). Neoadjuvant chemotherapy resulted in pathologic downstaging to ≤pT1N0 in 62% of tumors compared with only 9% treated with initial surgery (odds ratio: 44.55; 95% confidence interval, 10.39–191). Eight patients with clinically node-positive disease had surgical consolidation with cystectomy and extended lymph node dissection after clinical complete response to chemotherapy. Median OS and DSS in this group of patients were 23.3 mo and 21.8 mo, respectively, with 5-yr OS and DSS of 38%. Conclusions Neoadjuvant chemotherapy is associated with a high rate of pathologic downstaging and correlates with significantly higher survival compared with historical expectations. Although limited by a small sample size and retrospective analysis, in the context of a rare disease, this experience suggests neoadjuvant chemotherapy as a standard approach in treating SCUC.

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Small Cell Carcinoma of the Urinary Bladder Treated with Chemotherapy and Radiotherapy: Results in Five Cases

Cited by 53 publications

References 15 publications

A rare bladder cancer - small cell carcinoma: review and update

A rare bladder cancer - small cell carcinoma: review and update

Small Cell Carcinoma of the Urinary Bladder

Neoadjuvant Chemotherapy in Small Cell Urothelial Cancer Improves Pathologic Downstaging and Long-term Outcomes: Results from a Retrospective Study at the MD Anderson Cancer Center

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