Small Cell Cancer of the Bladder and Prostate: A Retrospective Review from a Tertiary Cancer Center.

Shahida Ahmed,Rashmi Koul,Naseer Ahmed,Sam Neufeld,Darrel E Drachenberg,Katie Galloway,Tadeusz J Kroczak,Piotr Czaykowski,Bashir Bashir,Ibrahim Aljada

doi:10.7759/cureus.296

Abstract

Background: Genitourinary small cell cancer (GUSCC) is a rare malignancy. Most of the published data on how to manage this malignancy is based on institutional experience. We undertook the current retrospective review to determine the outcome of the patients with GUSCC treated at CancerCare Manitoba, Canada over a period of 18 years.Methods: The Manitoba Cancer Registry was used to identify patients with a confirmed pathological diagnosis of small cell cancer (SCC) of the bladder or prostate between January 1, 1995, and October 31, 2013.Results: There were 42 patients identified, 28 bladder SCC (17 limited, 11 extensive stage) and 14 prostate SCC (one limited, 12 extensive, and one unknown stage). The median age was 70.7 years. There were 22 patients who were treated with chemotherapy and radiation, five received radiation only, four received chemo only, nine did not receive any treatment, one patient had surgery only, and one had surgery and radiation. The median and one-year overall survival for all patients was 10.7 months and 43%. The median and one-year overall survival of SCC of the bladder was 55.1 months and 71% for the limited stage and 10.1 months and 36% for the extensive stage. The median and one-year overall survival for extensive stage SCC of the prostate was 4.1 months and 17%. There was only one patient with limited stage SCC of the prostate who did not receive any treatment and died of progressive disease 11 months from diagnosis.Conclusions: Our findings suggest that patients with limited stage SCC of the bladder can have a surprisingly good outcome with multimodality treatment. The outcome of the patients with extensive stage SCC of the bladder and prostate remains dismal and optimal therapeutic options have yet to be determined.

Highlights

Extrapulmonary small cell cancer (EPSCC) is a rare malignancy and was first introduced in the medical literature as a separate clinicopathological disease entity in 1930 [1,2,3]
There were 22 patients who were treated with chemotherapy and radiation, five received radiation only, four received chemo only, nine did not receive any treatment, one patient had surgery only, and one had surgery and radiation
Our findings suggest that patients with limited stage SCC of the bladder can have a surprisingly good outcome with multimodality treatment

Summary

Introduction

Extrapulmonary small cell cancer (EPSCC) is a rare malignancy and was first introduced in the medical literature as a separate clinicopathological disease entity in 1930 [1,2,3]. The pathogenesis of genitourinary small cell carcinoma (GUSCC) is poorly understood. It has been proposed that small cell cancer (SCC) develops from the metaplasia of other high-grade tumors, such as transitional cell carcinoma. This fails to explain the existence of EPSCC in the absence of other malignancies. Differentiation from a common pluripotent stem cell has been proposed, which could account for both the existence of EPSCC in the absence of other tumor types and for their tendency to be present together [7,8,9,10]. Genitourinary small cell cancer (GUSCC) is a rare malignancy. We undertook the current retrospective review to determine the outcome of the patients with GUSCC treated at CancerCare Manitoba, Canada over a period of 18 years

Methods

Results

Discussion

Conclusion