title: Genitourinary small-cell carcinoma: a single-institution experience.
abstract: BACKGROUND
  Small-cell carcinomas (sccs) of the genitourinary (gu) tract are rare systemic diseases, and there is no standard treatment strategy for patients with this malignancy. The objectives of the present study were to report the management and outcome of patients with scc of the gu tract treated at a tertiary-care institution from 1982 to 2009.
  
  
  METHODS
  In a chart review of all patients diagnosed with scc of the gu tract between 1982 and 2009, data on demographics, clinical and pathologic characteristics, treatment, and patient outcomes were collected.
  
  
  RESULTS
  The 58 patients identified had scc in the following primary sites: urinary bladder (n = 35), prostate (n = 17), and upper urinary tract (n = 6). In 38 patients (66%), the scc was of pure histology; in the remainder, histology was mixed. Overall, 28 patients had limited-stage disease; 24 had extensive-stage disease; and staging was unknown in 6 patients. Median survival for the entire cohort was 7.5 months, with extensive-stage disease being identified as a poor prognostic factor (survival was 22.0 months for limited-stage patients and 4.1 months for extensive-stage patients, p < 0.001). Based on site, prostate patients fared worst, with a median survival of only 5.1 months. Compared with best supportive care, treatment was associated with better outcomes (median survival: 12.3 months vs. 2.3 months, p < 0.0001).
  
  
  CONCLUSIONS
  Small-cell cancer of the gu tract is an aggressive cancer, with a poor prognosis overall. Although there is no standard of care, patients should be treated using a multimodality approach analogous to that used in the treatment of small-cell lung cancer.
authors.affiliation: Department of Radiation Oncology, University of Alberta and Cross Cancer Institute, Edmonton, AB.
authors.forename: N
authors.initials: N
authors.lastname: Pervez
authors.forename: F
authors.initials: F
authors.lastname: El-Gehani
authors.forename: K
authors.initials: K
authors.lastname: Joseph
authors.forename: A
authors.initials: A
authors.lastname: Dechaphunkul
authors.forename: M
authors.initials: M
authors.lastname: Kamal
authors.forename: D
authors.initials: D
authors.lastname: Pertschy
authors.forename: P
authors.initials: P
authors.lastname: Venner
authors.forename: S
authors.initials: S
authors.lastname: Ghosh
authors.forename: S
authors.initials: S
authors.lastname: North
keywords: Small-cell carcinoma; chemotherapy; genitourinary tract; radiation; retrospective review; surgery