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Local control rate and prognosis after sequential chemoradiation for small cell carcinoma of the bladder
Author(s) -
Meijer Richard P,
Meinhardt Wim,
Poel Henk G,
Rhijn Bas W,
Kerst J Martijn,
Pos Floris J,
Horenblas Simon,
Bex Axel
Publication year - 2013
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12038
Subject(s) - medicine , bladder cancer , cystectomy , carcinoma , chemotherapy , survival rate , urology , radiation therapy , transitional cell carcinoma , cancer , small cell carcinoma , surgery , oncology
Objectives To assess the long‐term outcome and the risk for local recurrence of patients with small cell carcinoma of the bladder ( SCCB ) treated with neoadjuvant chemotherapy followed by external beam radiotherapy (sequential chemoradiation). Methods All consecutive patients with primary small cell carcinoma of the bladder ( n = 66), treated in our institution between 1993 and 2011 were retrospectively evaluated from an institutional database. Only patients with limited disease ( Tx‐4N0‐1M0 ) small cell carcinoma of the bladder treated with sequential chemoradiation ( n = 27) were included in this study. Recurrence rates, overall survival and cancer‐specific survival were analyzed using the K aplan– M eier method. Results Median time to recurrence was 20 months, median overall survival 26 months, 5‐year overall survival 22.2%, median cancer‐specific survival 47 months and 5‐year cancer‐specific survival 39.6%. For complete responders after neoadjuvant chemotherapy ( n = 19), median cancer‐specific survival was 52 months with a 5‐year cancer‐specific survival 45.9% versus a median cancer‐specific survival of 22 months and 5‐year cancer‐specific survival 0.0% for incomplete responders ( n = 8; P = 0.034). Eight patients (29.6%) underwent transurethral resections ( TUR‐BT ) for local recurrences in the bladder. At the end of follow up, four patients had undergone cystectomy for recurrence of disease resulting in a bladder‐preservation rate of 85.2%. Median time to local recurrence was 29 months and median time to distant recurrence was 10 months. Conclusions Sequential chemoradiation for limited disease small cell carcinoma of the bladder results in a reasonable outcome with a high bladder preservation rate. Response to neoadjuvant chemotherapy represents a significant prognostic factor in this patient population.