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Primary small cell carcinoma of the urinary bladder: a 10-year retrospective review of treatment and survival at a single institution

Xue-Jun Liu, Cheng Liu, Duo Liu, Dong-Wei Yao

Objective: Primary small cell carcinoma of the urinary bladder (SCBC) is a rare condition. SCBC accounts for less than 1% of all urinary bladder tumors. The purpose of this study is to report the clinical experience, clinical features, treatment modalities and overall survival of patients diagnosed with SCBC.

Patients and Methods: There were 12 patients who were diagnosed with SCBC between January 2002 and December 2012 at our institution. The features of the patients, including age, gender, smoking history, presenting symptoms, tumor size, tumor locations, treatment modalities, stages, pathology appearance, recurrence and overall survival, were retrospectively analyzed.

Results: Twelve patients were diagnosed with SCBC (male: female ratio, 3:1; mean age, 69.8 ± 7.1 y; mean follow-up, 18.3 ± 5.6 months). Nine of these patients had a history of smoking. Eleven patients presented with gross hematuria, and the other patient presented with urinary frequency. Only one patient had stage I disease; eight patients had stage III disease, and the other three patients had stage IV disease. The mean tumor size was 4.62 ± 1.33 cm in diameter. Nine patients were treated with surgery (six patients underwent radical cystectomy, and three patients underwent TUR-BT); the other three patients received sequential chemoradiotherapy because of the presence of lymph node or distant metastasis at the time of the initial diagnosis. Overall, eight patients were treated with chemotherapy. At the time of data analysis, only one patient was alive. The median survival time of all patients was 14 months. The median survival time was 19 months for patients receiving chemotherapy compared to 12.5 months for patients who did not receive chemotherapy.

Conclusion: Although many efforts have been made to treat SCBC, there is still no standard strategy for treatment. Despite the high response rate to chemotherapy, the overall prognosis is poor. SCBC is an aggressive disease with a propensity for early metastasis. Prospective multi-institutional randomized studies are needed to establish the best treatment modalities. New molecular markers for early diagnosis and novel targeted therapies may play important roles in the future.