A recent study published in Scientific Reports has shed light on the treatment and survival outcomes of patients with non-metastatic small cell carcinoma of the bladder (SCCB). The retrospective analysis, encompassing 20 patients, highlights the importance of radical treatment approaches and provides valuable insights into the management of this rare and aggressive malignancy.
The study, which reviewed patient data from multiple institutions, revealed a median overall survival (OS) of 65.3 months for the entire cohort. Patients with localized disease had a median OS of 65.3 months, while those with locally advanced disease had a median OS that was not reached during the follow-up period. The 1-year, 2-year, and 3-year OS rates for the entire cohort were 85%, 68%, and 60%, respectively.
Treatment Strategies and Outcomes
The study found that 13 patients received local treatment (PC and TURBT) and 7 patients received radical treatment (RC and RT). Radical treatment was associated with improved survival outcomes compared to local treatment. The median OS for patients receiving local treatment was 65.3 months, while the median OS for those receiving radical treatment was not reached. The 1-year, 2-year, and 3-year OS rates for the radical treatment group were 100%, 100%, and 75%, respectively.
A total of 18 patients (90%) received chemotherapy (CT). The most commonly used CT regimen was etoposide and cisplatin (45%), administered intravenously every 3 weeks for 4 to 6 cycles. This regimen is based on the standard treatment for small cell lung cancer (SCLC), reflecting the histological similarities between the two malignancies.
Patterns of Failure
During the median follow-up period of 65.8 months, locoregional recurrence occurred in 2 patients, distant metastasis developed in 3 patients, and both occurred in 6 patients. The most common sites of distant metastases were the liver (25%), brain (15%), and bone (15%). The vast majority (89%) of distant metastases occurred within 14 months of diagnosis.
Implications for Clinical Practice
The findings of this study underscore the importance of aggressive treatment strategies, including radical cystectomy and chemoradiation therapy, in patients with non-metastatic SCCB. The use of etoposide and cisplatin-based chemotherapy regimens, adapted from SCLC protocols, appears to be effective in this patient population. Further research is needed to identify novel therapeutic targets and improve outcomes for patients with this challenging disease.
