4545 Background: SCC of the bladder (SCCB), prostate (SCCP), and kidney (SCCK) remains a therapeutic challenge. Much debate exists in the literature about the ideal course of therapy. Methods: All charts of all patients seen at the ORCC between 1991–2002 for any GU diagnosis were manually reviewed to identify GUSCC. Demographic, staging, treatment and outcome data was extracted. The Veterans Administration small cell lung cancer classification of limited and extensive disease was adapted to the genitourinary system(limited:disease localized to the true and false pelvis, extensive:disease beyond the pelvis). Results: 555, 858 and 5066 new cases of primary renal, bladder and prostate cancer respectively, were identified. Of these cases, 22 patients were GUSCC: 12 SCCB, 10 SCCP and no SCCK. 8/12 SCCB had limited disease. 5 patients with SCCB are alive and were all limited at diagnosis. Surviving patients received similar therapy with transurethral resection of the bladder tumor, platinum chemotherapy, etoposide (4–6 cycles), and radical radiotherapy (56–60 Gray). All cases of SCCP have died. 2/10 had limited stage. Of these two patients one was treated with platinum chemotherapy and etoposide followed by radical radiotherapy (66 Gray), the other patient had a poor performance status at diagnosis and was treated with palliative hormonal ablation and radiotherapy. Our table illustrates the median survival according to site and stage (SCCB and SCCP combined) at diagnosis. Conclusions: Our findings support that GU SCC is an aggressive cancer. We have found that limited stage SCCB and SCCP, when treated with platinum/etoposide chemotherapy along with radical radiotherapy tends to have a more favourable outcome than that of extensive GUSCC. No significant financial relationships to disclose.