Outcome of recurrent and metastatic small cell carcinoma of the bladder

Nabil Ismaili,Wafaa Kaikani,Aude Flechon,Agathe Bajard,Jean Pierre Droz,Hassan Errihani,Mohammed Ismaili,Pierre Etienne Heudel,Fadi Elkarak

doi:10.1186/1471-2490-9-4

Abstract

BackgroundBladder small cell carcinoma is an uncommon tumour. Through a retrospective study we will present the evolution of recurrent and metastatic disease and outcome of patients treated at Léon-Bérard Cancer Centre.MethodsOnly 15 patients having recurrent or metastatic bladder small cell carcinoma were treated at Léon-Bérard Cancer Centre between 1996 and 2007. The patients were divided in two groups: a mixed small cell carcinoma group (9 patients) and a pure small cell carcinoma group (6 patients). All the records and informations related to treatment and outcome of the 15 patients were retrospectively analyzed. Various characteristics of small cell carcinoma were investigated.ResultsThe median age of the 15 patients having recurrent or metastatic bladder small cell carcinoma and treated at Léon-Bérard Cancer Centre was 63 years and the disease was at stage IV for all cases. Nine patients were treated by chemotherapy. Four patients were treated by local radiotherapy (3 with radiotherapy without previous surgery and 1 with surgery followed by radiotherapy) and chemotherapy. One patient was treated by whole brain radiotherapy. And one patient died before treatment. After 52.4 months median follow up, 12 patients died. Median overall survival was 7.6 months. Survival probability at 1 year was 33%. Median overall survival was 9.9 months in the mixed small cell carcinoma group, and was only 4.6 months in the pure small cell carcinoma group. Survival probability at 1 year in the mixed small cell carcinoma group was 44% as compared to 17% in the pure small cell carcinoma group (Log-rank test: p = 0.228).ConclusionRecurrent and metastatic bladder small cell carcinoma is associated with very poor prognosis. The pure bladder small cell carcinoma appears to have poorer outcome than the mixed bladder small cell carcinoma. Chemotherapy using platinum drugs is a mainstay treatment.

Highlights

IntroductionThrough a retrospective study we will present the evolution of recurrent and metastatic disease and outcome of patients treated at Léon-Bérard Cancer Centre
Bladder small cell carcinoma is an uncommon tumour
Whereas small cell cancer is a common histological variant accounting for 14% of all primitive cancers arising from the lung [1], small cell carcinoma of the bladder (SCCB) is extremely rare and accounts for less than 1% of all cancers arising from the bladder [2,3]

Summary

Introduction

Through a retrospective study we will present the evolution of recurrent and metastatic disease and outcome of patients treated at Léon-Bérard Cancer Centre. The diagnosis of SCCB is based on criteria established by the WHO classification system Those criteria are identical to those used to diagnose small cell lung cancer (SCLC) [5]. Immunochemical staining can be extremely helpful in establishing the diagnosis. This tumour is associated with a more aggressive behaviour and poorer prognosis than transitional cell bladder carcinoma (TCC), and is mostly diagnosed at advanced stages. We conducted a retrospective analysis of all cases of recurrent or metastatic small cell carcinoma of the bladder treated at the LéonBérard Cancer Centre over a 12-year period for definition of patient's outcome

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Discussion

Conclusion