title: Clinical management of small-cell carcinoma of the urinary tract: a 10-year single-center's experience.
abstract: BACKGROUND
  Small-cell carcinoma (SCC) comprises 1% of primary bladder tumors and approximately 2% of prostate neoplasms. Metastatic disease at diagnosis is common, and survival outcomes are extremely poor. There is controversy about the ideal clinical management of these patients. The neuron-specific enolase (NSE) serum levels have never been studied in patients with small-cell carcinoma of the urinary tract (SCCUT).
  
  
  METHODS
  We report the clinical outcome of 12 consecutive SCCUT patients treated during the past 10 years. We also study the NSE levels at diagnosis and during treatment.
  
  
  RESULTS
  Patients with limited disease (LD) experienced a non-significant longer progression-free survival (PFS) and overall survival (OS) compared with extensive disease (ED) subjects. Patients with bladder SCC showed a significantly higher median PFS compared with prostate SCCUT patients (22 vs. 6 months; P = .034), although that difference did not impact on a significant longer OS. NSE levels decreased during chemotherapy administration in all patients with ED and baseline high levels.
  
  
  CONCLUSIONS
  Our patients showed a poor prognosis as described in previous studies. A better outcome for patients with bladder SCC compared with prostate SCC could be suggested. Serum NSE levels should be further evaluated to prove its potential use in early diagnosis and treatment monitoring during chemotherapy.
authors.affiliation: Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: Omar E
authors.initials: OE
authors.lastname: Carranza
authors.forename: Eduardo
authors.initials: E
authors.lastname: Castañón
authors.forename: Luis E
authors.initials: LE
authors.lastname: Abella
authors.forename: María E
authors.initials: ME
authors.lastname: Zudaire
authors.forename: Ainhoa
authors.initials: A
authors.lastname: Castillo
authors.forename: Estefanía
authors.initials: E
authors.lastname: Arévalo
authors.forename: Juan P
authors.initials: JP
authors.lastname: Fusco
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Zudaire
authors.forename: Rafael
authors.initials: R
authors.lastname: Carías
authors.forename: Mauricio
authors.initials: M
authors.lastname: Cambeiro
authors.forename: Rafael
authors.initials: R
authors.lastname: Martínez-Monge
authors.forename: Ignacio
authors.initials: I
authors.lastname: Gil-Bazo
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D018288:Carcinoma, Small Cell / Q000097:blood / Q000188:drug therapy / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000097:blood / Q000188:drug therapy / Q000401:mortality; D008297:Male; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000097:blood / Q000188:drug therapy / Q000401:mortality; D014551:Urinary Tract / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D010751:Phosphopyruvate Hydratase