886 - Clinical Management of Small-Cell Carcinoma of the Urinary Tract(SCCUT): A 10-Year Single-Center's Experience

Abstract

ABSTRACT Purpose This study aimed to review the clinical features, therapeutic management and natural course of patients with small-cell carcinoma of the urinary tract (SCCUT), based on our own clinical experience. Material and methods From March 2002 to February 2012 twelve patients were diagnosed with SCCUT and started treatment at the Clinica Universidad de Navarra, Pamplona (Spain). Results The primary tumor site was prostate in 6/12 (50%), urinary bladder in 5/12 (41.7%) and kidney in 1/12 (8.3%) of the cases. Overall, 5 patients (41.7%) had limited disease (LD) and 7 (58.3%) had extensive disease (ED) at the time of diagnosis. Neuron-Specific Enolase (NSE) serum levels were determined in 5 patients at onset. In all of them, levels over the upper-limit were observed. Detailed treatment information was available in 10 patients, 5 with LD and 5 with ED. LD patients were treated in a multimodality fashion. After a median follow-up of 26 months, median progression-free survival (PFS) for patients with LD was 22 months (range 7–40). Median overall survival (OS) was 26 months (range 11–40). Patients showing ED mostly received palliative chemotherapy. The overall response rate for chemotherapy in this cohort was 75%; 2/4 achieved a complete response, 1/4 a partial response and 1/4 showed disease stabilization. After a median follow-up of 12 months, the median PFS was 11 months (range 3–14). The median OS was 14 months (range 12–38) for the ED cohort. However, the differences observed in PFS and OS between LD and ED cohorts did not achieve statistical significance. In addition, patients with bladder SCCUT showed a statistically significant longer PFS (22 months) compared to patients with a prostatic origin (6 months). Conclusions Despite its chemosensitivity, SCCUT showed an aggressive clinical course and poor prognosis in our series. Bladder origin SCCUT may have a better prognosis than those from prostate origin. NSE serum levels may help to achieve an early diagnosis and to provide a proper systemic treatment up-front. Disclosure All authors have declared no conflicts of interest.