Multidisciplinary approach in the treatment of patients with small cell bladder carcinoma

Abstract

Small cell carcinoma of the urinary bladder (SCCUB) is considered to be a tumor with a neuroendocrine phenotype characterised by aggressive behaviour and poor prognosis. Small cell carcinoma of the urinary bladder comprises 0,35 to 1% of all bladder cancers and is frequently observed in combination with other histological subtypes of carcinoma. Clinical presentation is characterized by advanced stage at diagnosis and rapidly progressive disease. In daily clinical practice there is no gold standard for the management of patients affected by this disease. Treatment of patients with limited disease combines neoadjuvant platinum-based chemotherapy followed by specific local treatment of the primary tumour. Cystectomy or radiotherapy should be proposed on an individual basis. In the metastatic setting, prognosis remains poor with a potential benefit from chemotherapy containing platinum compounds. Treatment of small cell carcinoma of the urinary bladder is based on evidence obtained from case reports and retrospective analyses. Due to low disease frequency there is a lack of randomized trials to provide guidance as to optimal therapy. Thus, systemic and local approaches are extrapolated from the literature available for the treatment of small cell carcinomas at other (nonurological) sites. We provide an overview of the currently available literature with it's main focus on the treatment of either locally advanced or metastatic small cell carcinoma of the urinary bladder.

Carcinome neuroendocrine de la vessie: à propos de 5 cas

“…Le taux de survie globale à cinq ans tous stades confondus est de 19% (16 à 25%). Le pronostic des carcinomes neuroendocrines purs semble être plus défavorable que celui des formes mixtes (9,5 contre 34 mois) [3, 6, 14]. …”

The Colorful Palette of Neuroendocrine Neoplasms in the Genitourinary Tract

“…Early diagnosis of the disease as well as surgery, neoadjuvant, adjuvant, or palliative chemotherapy with or without radiotherapy are the cornerstones of patient care (13,(48)(49)(50). Details about prognosis and therapy are shown in Table III (13,23,35,41,42,44,(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60).…”

Primary Metastatic Neuroendocrine Small Cell Bladder Cancer: A Case Report and Literature Review

“…The MDACC trial [22] reported 78% of cancer-specific survival in 21 patients treated with chemotherapy plus radical cystectomy. Radiation therapy is applied as a local treatment with a similar result to surgery following a platinum-based chemotherapy with 56-70 Gy [23] . In a study of 15 patients treated with radiation therapy plus chemotherapy there is evidence of a complete response in 88% and a median overall survival of 32.5 months [24] .…”