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Open Access Highly Accessed Research article

Outcome of recurrent and metastatic small cell carcinoma of the bladder

Nabil Ismaili12*, Pierre Etienne Heudel2, Fadi Elkarak2, Wafaa Kaikani12, Agathe Bajard3, Mohammed Ismaili4, Hassan Errihani1, Jean Pierre Droz2 and Aude Flechon2

Author Affiliations

1 Department of Medical Oncology, National Institute of Oncology, Rabat-10000, Morocco

2 Department of Medical Oncology, Centre Léon-Bérard, 28 Rue Laennec, Lyon-69008, France

3 Department of Biostatistics, Centre Léon-Bérard, 28 Rue Laennec, Lyon-69008, France

4 Department of Microbiology, Moulay Ismail University, Meknes-50000, Morocco

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BMC Urology 2009, 9:4  doi:10.1186/1471-2490-9-4

Published: 6 June 2009

Abstract

Background

Bladder 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.

Methods

Only 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.

Results

The 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).

Conclusion

Recurrent 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.