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Table 3 Treatment strategies and outcome of bladder small cell carcinoma according to the most important studies published in the English literature.

From: A rare bladder cancer - small cell carcinoma: review and update

Authors

No

Study design

Stages (No)

Treatments (No)

Results and comments

Blomjous 1989 [2]

18

Retrospective

T2(5)

T3(8)

T4(5)

CT group

TURBT→RT→CT(2)

TURBT→CT(1)

RC→CT(1)

CT→RC(1)

-OS and 2 years survival in the whole group = 9 months and 27.7% respectively

-OS and Survival at 2 years in CT group vs. no CT group = NR vs. 7 months and 60% vs. 15.5%, respectively

    

Non-CT group

TURBT→RT(9)

RC(3)

None(1)

 

Holmang 1995 [3]

25

Retrospective

T2(7)

T3(10)

T4(2)

IVM+(6)

RC→RT(18)

CT(2)

None(5)

5 years survival in the whole group = 20%

Lohrisch 1999 [4]

14

Retrospective

LD(9)

ED(1)

CT group

CT→RT(8)

CT→RC(1)

CT→C(1)

-OS in the CT grope = 41 months

-Survival at 5 years = 70% in the CT group vs. 0% in the non CT group

   

LD(2); ED(2)

Non-CT group

RT(2)

None(2)

 

Bastus 1999 [32]

5

Retrospective

T2(1)

T3(3)

T3N1(1)

CT→RT(5)

-All patients were treated with sequential chemo-radiotherapy;

-2 years survival in the whole group = 80%

Siefker-Radtke 2004 (MD Anderson) [12]

46

Retrospective cohort

T2(13)

T3-T4a(8)

CT→RC(21)

5 years survival in neoadjuvant CT group was significantly better than surgery alone group = 78% vs. 36%, p = 0.026

   

T2(12)

T3-T4a(7)

Unknown(n = 6)

RC(25)

 

Cheng 2004 [8]

64

Retrospective cohort

T1(1)

T2(30)

T3(29)

T4(4)

RC(38)

RT(10)

CT(23)

No difference in survival between RC group vs. non-RC group

Mangar 2004 [14]

14

Retrospective

T3(8)

T3N1(1)

T4 (2)

IVM+(3)

RC group

RC→CT→RT(1)

RC→RT(3)

RC(2)

Outcome in RC group > outcome in non-RC group

    

Non-RC group

PRT(5)

None(3)

 

Choong 2005 (Mayo Clinic) [5]

44

Retrospective

II(12)

RC(7)

NCT→RC(1)

PC(3)

-5 years survival in the whole group = 25%

-5 years survival in stage II > III/IV = 63%, 15%, and 10% respectively, p< 0.001;

-No difference between stages III and IV

   

III(13)

RC(8)

RC→CT(2)

 
   

IV(19)

RC→CT(10)

RC(2)

CT(5)

 

Bex 2005 [10]

25

Prospective

LD(10)

ED(3)

CT group

CT(13)→RT(8)

CT > non-CT (OS = 15 vs. 4 months respectively, p = 0.003)

   

LD(7)

ED(5)

Non-CT group

RT(5)

RC(3)

P(4)

 

Quek 2005 [6]

25

Retrospective

I/II(4)

III(2)

IV N+ or M+(19)

RC→ACT(13)

NCT→RC(1)

RC(11)

-Survival in mixed SCCB > survival in pure SCCB, p = 0.06

-RC + ACT > RC alone

Mukesh 2008 [13]

20

Retrospective

LD(11); ED(9)

CT group(13)

CT→RT(6)

RC→CT(7)

Outcome in CT group > outcome in non-CT (OS = 33 months vs. 3 months, respectively)

    

Non-CT group(7)

BSC(4)

RC(4)

RT(1)

 

Ismaili 2008 [7]

14

Retrospective

II(4)

III(5)

IVM0(5)

RC→CT(4)

RC(5)

CT→RC(2)

CT(1)

RCT(1)

None(1)

-Survival in mixed SCCB > survival in pure SCCB, p = 0.01,

-CT + Surgery > Surgery

Bex 2009 [15]

17

Retrospective

LD(17):

-T2(14)

-T3(2)

-T4a(1)

CT→RT (60: 56-70Gy) (17)

Salvage RC (3)

-All patients have been treated with sequential chemoradiotherapy

-OS = 32.5 months

-2, 3, and 5 years survival = 56%, 47%, and 36% respectively

Siefker-Radtke 2009 (MD Anderson) [33]

30

Phase II

Resecable patients(18): T2N0M0

CT→RC

-5 years survival in operable group = 80%

-OS = 58 months vs 13.3 months, in operable vs non operable patients, respectively

-Incidence of brain metastasis in stage III/IV = 50%

   

Unresecable patients(12): T3b-4aN0M0

CT alone

 

Bex 2010 [40]

51

Retrospective

LD(39)

CT→RT

-Survival of patients with LD = 35 months vs 6 months in patients with ED.

-Incidence of brain metastasis = 10.5%

   

ED(12)

CT

 
  1. Abbreviations. OS = overall survival; NS = no significant; RC = radical cystectomy; TURBT = transurethral resection of the bladder tumour; ACT = adjuvant chemotherapy; NCT = neoadjuvant chemotherapy; PC = partial cystectomy; CT = chemotherapy; RCT = concurrent chemoradiotherapy; PRT = palliative radiotherapy; NR = no reached; LD = limited disease; ED = extensive disease; SCCB = small cell carcinoma of the bladder; Definition for LD (limited disease): in analogy to SCLC, patient with any local stage, no distant metastases and involvement of maximally one loco regional lymph node less than 2 cm in imaging (cTx cN0-1 M0) [15]; Definition for ED (extensive disease): unresectable and metastatic disease [15].
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Orphanet Journal of Rare Diseases

ISSN: 1750-1172