title: Outcome of recurrent and metastatic small cell carcinoma of the bladder.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medical Oncology, National Institute of Oncology, Rabat, Morocco. ismailinabil@yahoo.fr
authors.forename: Nabil
authors.initials: N
authors.lastname: Ismaili
authors.forename: Pierre Etienne
authors.initials: PE
authors.lastname: Heudel
authors.forename: Fadi
authors.initials: F
authors.lastname: Elkarak
authors.forename: Wafaa
authors.initials: W
authors.lastname: Kaikani
authors.forename: Agathe
authors.initials: A
authors.lastname: Bajard
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ismaili
authors.forename: Hassan
authors.initials: H
authors.lastname: Errihani
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Droz
authors.forename: Aude
authors.initials: A
authors.lastname: Flechon
mesh_terms: D000368:Aged; D018288:Carcinoma, Small Cell / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy