Bladder preservation and durable complete remission of small cell carcinoma of the bladder with systemic chemotherapy and adjuvant radiation therapy.

Abstract

Small cell (oat cell) carcinoma of the bladder is a rare entity characterized clinically by an aggressive behavior with a high incidence of systemic metastases. Radical cystectomy has been the therapeutic focal point for this disease, but systemic relapse is almost universal. The authors report that combination chemotherapy with cisplatin, methotrexate, and vinblastine, followed by external beam irradiation to the bladder, gave a durable continuous complete remission (more than 4.5 years). In addition, this bladder-sparing approach has preserved normal bladder function and an excellent quality of life. This experience shows that radical cystectomy may not be necessary for small cell carcinoma of the bladder and that early intervention with systemic chemotherapy offers greater potential for cure.