INTRODUCTION: Small cell carcinoma (SCC) of the bladder is a relatively rare tumor type, and consequently, the volume of literature surrounding its treatment remains limited.
We sought to elaborate patterns of care and survival after treatment in the largest series of patients with locoregional SCC of the bladder to date.
METHODS: We identified patients with localized/locally advanced (cTis-cT4, cN0, cM0) bladder SCC diagnosed between 1998 and 2010 from the National Cancer Database (NCDB). Treatment was categorized as bladder preservation therapy (BPT), radical cystectomy alone (RC), BPT with multimodal treatment (BSS/MMT), or RC with multimodal treatment (RC/MMT). We performed a Kaplan-Meier overall survival (OS) analysis to evaluate for differential survival between treatment groups.
RESULTS: A total of 625 patients met our inclusion criteria. The median age at diagnosis was 73 years (range 36-90) and 65% of patients presented with cT2 disease. When stratified by treatment type 174 (27.8%) underwent BPT, 333 (53.3%) underwent BPT+MMT, 46 (7.4%) underwent RC, and 72 (11.5%) underwent RC+MMT. The 3-year OS was 23% [95% CI: 15%-32%], 35% [30%-45%], 38% [17%-60%], and 30.1% [16%-47%] for BPT, BPT+MMT, RC, and RC+MMT respectively. The OS was most favorable with RC+ neoadjuvant chemotherapy with a 3-year OS of 53% [95%CI: 19%-79%].
CONCLUSION: In the US, locoregional small cell carcinoma of the bladder predominantly occurs in Caucasian males with treatment in Metropolitan, Comprehensive Community Cancer Centers. The majority of patients were managed with BPT and most receive multimodal therapy. Patients receiving neoadjuvant chemotherapy followed by RC had the most favorable survival.
Written by:
Patel SG, Stimson CJ, Zaid HB, Resnick MJ, Cookson MS, Barocas DA, Chang SS. Are you the author?
Department of Urology, Vanderbilt University Medical Center, Nashville TN.
Reference: J Urol. 2013 Sep 11. pii: S0022-5347(13)05366-4.
doi: 10.1016/j.juro.2013.09.009
PubMed Abstract
PMID: 24036236
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