Background: Small cell carcinoma of the bladder is an uncommon but clinically aggressive disease. There is no standard surgical or medical management for the disease. Methods: Between 1995 and 2009, 28 patients underwent transurethral resection (TUR) and/or cystectomy, chemotherapy, and/or radiation for small cell carcinoma of the bladder at our institution. Results: The median follow-up for survivors was 34 months. Patients presented most often with muscle-invasive disease (T2-4 - 89%), and 21% had lymph node/distant metastases. Tobacco use and chemical exposure were noted in 64 and 4% of patients, respectively. Patients with T1-2N0M0 had a median survival of 22 months compared to 8 months for those with more advanced disease (p = 0.03). Patients with T3-4 or nodal/metastatic disease who were given chemotherapy had an improved survival compared to those with T3-4 or nodal/metastatic disease who did not undergo chemotherapy (13 vs. 4 months, p = 0.005). The median time to recurrence of the entire cohort was 8 months, overall and cancer-specific survival was 14 months, and 5-year survival was 11%. Conclusions: Small cell carcinoma of the bladder is an aggressive disease with poor outcomes. Patients with T1-2N0M0 disease survived longer than those with advanced disease. Patients with T3-4 or nodal/metastatic disease had improved survival with chemotherapy.

Keywords:
Small cell carcinoma, Bladder, Cystectomy, Chemotherapy, Radiation
1.
Koay EJ, Teh BS, Paulino AC, Butler EB: A surveillance, epidemiology, and end results analysis of small cell carcinoma of the bladder: epidemiology, prognostic variables, and treatment trends. Cancer 2011;117:5325-5333.
2.
Bex A, Nieuwenhuijzen JA, Kerst M, Pos F, van Boven H, Meinhardt W, Horenblas S: Small cell carcinoma of bladder: a single-center prospective study of 25 cases treated in analogy to small cell lung cancer. Urology 2005;65:295-299.
3.
Choong NW, Quevedo JF, Kaur JS: Small cell carcinoma of the urinary bladder. The Mayo Clinic experience. Cancer 2005;103:1172-1178.
4.
Grignon DJ, Ro JY, Ayala AG, Shum DT, Ordóñez NG, Logothetis CJ, Johnson DE, Mackay B: Small cell carcinoma of the urinary bladder. A clinicopathologic analysis of 22 cases. Cancer 1992;69:527-536.
5.
Bex A, de Vries R, Pos F, Kerst M, Horenblas S: Long-term survival after sequential chemoradiation for limited disease small cell carcinoma of the bladder. World J Urol 2009;27:101-106.
6.
Holmäng S, Borghede G, Johansson SL: Primary small cell carcinoma of the bladder: a report of 25 cases. J Urol 1995;153:1820-1822.
7.
Siefker-Radtke AO, Dinney CP, Abrahams NA, Moran C, Shen Y, Pisters LL, Grossman HB, Swanson DA, Millikan RE: Evidence supporting preoperative chemotherapy for small cell carcinoma of the bladder: a retrospective review of the M. D. Anderson cancer experience. J Urol 2004;172:481-484.
8.
Lester JF, Hudson E, Barber JB: Bladder preservation in small cell carcinoma of the urinary bladder: an institutional experience and review of the literature. Clin Oncol (R Coll Radiol) 2006;18:608-611.
9.
Siefker-Radtke AO, Kamat AM, Grossman HB, Williams DL, Qiao W, Thall PF, Dinney CP, Millikan RE: Phase II clinical trial of neoadjuvant alternating doublet chemotherapy with ifosfamide/doxorubicin and etoposide/cisplatin in small-cell urothelial cancer. J Clin Oncol 2009;27:2592-2597.
10.
Mukesh M, Cook N, Hollingdale AE, Ainsworth NL, Russell SG: Small cell carcinoma of the urinary bladder: a 15-year retrospective review of treatment and survival in the Anglian cancer network. BJU Int 2009;103:747-752.
11.
Ordóñez NG, Khorsand J, Ayala AG, Sneige N: Oat cell carcinoma of the urinary tract. An immunohistochemical and electron microscopic study. Cancer 1986;58:2519-2530.
12.
Mills SE, Wolfe JT 3rd, Weiss MA, Swanson PE, Wick MR, Fowler JE Jr, Young RH: Small cell undifferentiated carcinoma of the urinary bladder. A light-microscopic, immunocytochemical, and ultrastructural study of 12 cases. Am J Surg Pathol 1987;11:606-617.
13.
Christopher ME, Seftel AD, Sorenson K, Resnick MI: Small cell carcinoma of the genitourinary tract: an immunohistochemical, electron microscopic and clinicopathological study. J Urol 1991;146:382-388.
14.
Cheng L, Pan CX, Yang XJ, Lopez-Beltran A, MacLennan GT, Lin H, Kuzel TM, Papavero V, Tretiakova M, Nigro K, et al: Small cell carcinoma of the urinary bladder: a clinicopathologic analysis of 64 patients. Cancer 2004;101:957-962.
15.
Lynch SP, Shen Y, Kamat A, Grossman HB, Shah JB, Millikan RE, Dinney CP, Siefker-Radtke A: 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. Eur Urol 2013;64:307-313.
© 2015 S. Karger AG, Basel
2015
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