Small Cell Carcinoma of the Urinary Bladder: A Retrospective, Multicenter Rare Cancer Network Study of 107 Patients
- Academic Radiation Oncology Department, Centre Oscar Lambret, Lille (France)
- Mayo Clinic, Rochester, Minnesota (United States)
- Department of Oncology, Nottingham University Hospitals National Health Service Trust, Nottingham (United Kingdom)
- Department of Radiation Oncology, Radboud university medical center, Nijmegen (Netherlands)
- Radiation Oncology, Catalan Institute of Oncology, H. Universitari Germans Trías, Badalona, Barcelona (Spain)
- Division of Oncology, Rambam Health Care Campus and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa (Israel)
- Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland)
- Department of Radiation Oncology, Bern University Hospital, Bern (Switzerland)
- Department of Oncology, Aarhus University Hospital, Aarhus (Denmark)
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk (Poland)
- Genesis Cancer Care, Southport (Australia)
- Institut Jules Bordet, Brussels (Belgium)
- Provincial Agency for Proton Therapy, Trento (Italy)
- Department of Radiation Oncology, Hopital de Sion, Sion (Switzerland)
- Department of Radiation Oncology, Geneva University Hospital, Geneva (Switzerland)
Purpose: Small cell carcinomas of the bladder (SCCB) account for fewer than 1% of all urinary bladder tumors. There is no consensus regarding the optimal treatment for SCCB. Methods and Materials: Fifteen academic Rare Cancer Network medical centers contributed SCCB cases. The eligibility criteria were as follows: pure or mixed SCC; local, locoregional, and metastatic stages; and age ≥18 years. The overall survival (OS) and disease-free survival (DFS) were calculated from the date of diagnosis according to the Kaplan-Meier method. The log-rank and Wilcoxon tests were used to analyze survival as functions of clinical and therapeutic factors. Results: The study included 107 patients (mean [±standard deviation, SD] age, 69.6 [±10.6] years; mean follow-up time, 4.4 years) with primary bladder SCC, with 66% of these patients having pure SCC. Seventy-two percent and 12% of the patients presented with T2-4N0M0 and T2-4N1-3M0 stages, respectively, and 16% presented with synchronous metastases. The most frequent curative treatments were radical surgery and chemotherapy, sequential chemotherapy and radiation therapy, and radical surgery alone. The median (interquartile range, IQR) OS and DFS times were 12.9 months (IQR, 7-32 months) and 9 months (IQR, 5-23 months), respectively. The metastatic, T2-4N0M0, and T2-4N1-3M0 groups differed significantly (P=.001) in terms of median OS and DFS. In a multivariate analysis, impaired creatinine clearance (OS and DFS), clinical stage (OS and DFS), a Karnofsky performance status <80 (OS), and pure SCC histology (OS) were independent and significant adverse prognostic factors. In the patients with nonmetastatic disease, the type of treatment (ie radical surgery with or without adjuvant chemotherapy vs conservative treatment) did not significantly influence OS or DFS (P=.7). Conclusions: The prognosis for SCCB remains poor. The finding that radical cystectomy did not influence DFS or OS in the patients with nonmetastatic disease suggests that conservative treatment is appropriate in this situation.
- OSTI ID:
- 22462386
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 92, Issue 4; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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