1905 INCIDENCE AND SURVIVAL OF SMALL CELL BLADDER CANCER

Abstract

You have accessJournal of UrologyBladder Cancer: Staging1 Apr 20111905 INCIDENCE AND SURVIVAL OF SMALL CELL BLADDER CANCER Joshua Meeks, Lee Zhao, John Cashy, and Shilajit Kundu Joshua MeeksJoshua Meeks Chicago, IL More articles by this author , Lee ZhaoLee Zhao Chicago, IL More articles by this author , John CashyJohn Cashy Chicago, IL More articles by this author , and Shilajit KunduShilajit Kundu Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2029AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Small cell bladder cancer (SCBC) is a rare and aggressive histologic subtype of bladder cancer thought to be derived in part from neuroendocrine cells. Given its rarity, the natural history, prognosis, and response to treatment have not been described. METHODS From the Surveillance, Epidemiology and End Results (SEER) National Cancer Registry, 498 patients with SCBC were identified between the year of 1998 and 2007. For comparison, 33624 patients with urothelial bladder cancer (UC) were identified for comparison. RESULTS The incidence of SCBC has increased over time from 0.8% to 2% of all cases of bladder cancer (p=0.0001) with an absolute increase of 14 to 77 cases per year from 1998 to 2007. The median age of diagnosis was 72 years, and 80% were male compared to 74% male of UC. The majority of patients with SCBC were white (89%). SCBC was more aggressive, with greater frequency of high grade compared to UC (42% vs. 31%), and muscle invasive disease at presentation (T2, 45% vs. 31%, p=0.001). In terms of treatment, a similar percentage of patients underwent radical cystectomy (18% with SCBC vs 19% with UC) and 19% had a lymph node dissection. Patients with SCBC were more likely to receive adjuvant radiotherapy (23% vs. 9%). Patients with SCBC had a higher rate of metastatic disease to regional lymph nodes (19% vs. 10%), with SCBC patients having higher rates of N1 (13% vs. 7%), N2 (6% vs. 3%) and N3 (0.4% vs. 0.3%) disease. Distant metastasis were present in 18% of SCBC compared to 7.5% in UC. At the time of diagnosis, 18% of patients with SCBC and only 8% of UC had evidence of metastatic disease. A significantly higher percentage of patients with SCBC died of bladder cancer compared to UC (54% vs. 32%, p=0.0001). For nearly every stage, SCBC had a higher cancer specific mortality including T1 (25% vs 14%, p=0.06), T2 (43% vs. 35%, p=0.04) and T3 (55% vs. 38%, p=0.02). Of those patients that died of bladder cancer, the mean time of survival was significantly shorter for SCBC (11 months vs. 15 months, p=0.0001). CONCLUSIONS SCBC is a rare and aggressive form of bladder cancer, with increasing incidence. Compared to standard UC, SCBC has a higher grade, stage, rate of metastasis and cancer-specific mortality. Patients with SCBC may benefit from early aggressive multi-modal therapy. Clinical Features of Patients with Small Cell Compared to Urothelial Bladder Cancer Small Cell BCa Urothelial BCa Age (years) 72 72 Gender (%male) 80 74 High Grade (%) 42 31 Muscle Invasion at Presentation (%) 45 31 Metastasis at Presentation (%) 18 8 Lymph Node Metastasis (%) 19 10 N1 13 7 N2 6 3 N3 .4 .3 Distant Metastasis 18 7.5 Overall Mortality 54 32 © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e762 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joshua Meeks Chicago, IL More articles by this author Lee Zhao Chicago, IL More articles by this author John Cashy Chicago, IL More articles by this author Shilajit Kundu Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...