title: Small cell carcinoma of the bladder: a search of the current literature.
abstract: OBJECTIVE
  Small cell carcinoma of the urinary bladder (SCC-BL) is an extremely rare malignancy, accounting for < 1% of all bladder tumors. Its prognosis is very poor because of its highly aggressive behavior and high metastatic potential. This study aimed to update the management and outcome of SCC-BL by searching the relevant international literature.
  
  
  METHODS
  Relevant studies were identified by searching MEDLINE and the Cochrane Central Register of Controlled Trials using a combination of terms such as small cell carcinoma, bladder cancer, therapeutic approach, radical cystectomy, radiation therapy and chemotherapy. Additional papers were identified from reviewing references of relevant articles.
  
  
  RESULTS
  Previously published series have shown that SCC-BL has a significant male predominance, occurs mainly during the 7th and 8th decade of life and macroscopic hematuria is the most common presenting symptom. According to the most important studies, cystectomy alone seems not to be efficient enough for the management of the disease. On the other hand, radiation therapy when combined with chemotherapy is highly effective with increased survival rates.
  
  
  CONCLUSIONS
  Poor prognosis and rarity render disease management complicated. A definitive treatment is not yet established but combined therapy with systemic platinum-based chemotherapy and adjuvant local radiotherapy seems to be the most effective therapeutic approach for limited-stage SCC-BL. Further research is required in order to clarify whether prophylactic cranial irradiation (PCI) should be performed on a regular basis.
authors.affiliation: Second Department of Radiation Oncology, Saint Savvas Anticancer Institute of Athens, Athens, Greece. kostasgkirlemis@hotmail.com
authors.forename: K
authors.initials: K
authors.lastname: Gkirlemis
authors.forename: A
authors.initials: A
authors.lastname: Miliadou
authors.forename: G
authors.initials: G
authors.lastname: Koukourakis
authors.forename: A
authors.initials: A
authors.lastname: Sotiropoulou-Lontou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000517:prevention & control / Q000556:secondary; D018288:Carcinoma, Small Cell / Q000150:complications / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D016371:Cranial Irradiation; D015653:Cystectomy; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D008297:Male; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000628:therapy*