Genitourinary small-cell carcinoma: 11-year treatment experience.
The predictive factors of prognosis and treatment strategies for small-cell carcinoma (SCC) of the urinary tract are controversial. This study was aimed to investigate the clinical experience and management of patients with SCC of the urinary tract. We collected data of patients who were diagnosed with genitourinary SCC (GSCC) between 2002 and 2013 and were treated in the Fudan University Shanghai Cancer Center. A total of 18 patients were diagnosed with GSCC of which 10 originated from the prostate, seven from the bladder and one from the adrenal gland. The mean follow-up time was 15.5 months and progression-free survival (PFS) was 9.3 months. Primary tumor resection was attempted in 13 of 18 patients (72.2%) in whom radical surgery was performed in six of 14 (42.9%) limited disease patients. Most of the patients (13, 72.2%) received cisplatin-based chemotherapy. Patients who had normal lactic dehydrogenase (LDH) levels showed a significantly higher median PFS and overall survival (OS) compared with patients with high LDH levels (P = 0.030, P= 0.010). Patients with limited disease treated with a radical operation experienced a non-significant (P = 0.211) longer PFS compared with patients who were not treated, but this reached statistical significance after analyzing OS (P = 0.211, P= 0.039). Our patients showed a poor prognosis as reported previously. Serum LDH levels beyond the normal range indicate a poor prognosis. For GSCC patients who are diagnosed with limited disease, radical surgery is strongly recommended along with cisplatin-based chemotherapy.
Kun
K
Chang
Bo
B
Dai
Yun-Yi
YY
Kong
Yuan-Yuan
YY
Qu
Hua-Lei
HL
Gan
Wei-Jie
WJ
Gu
Department of Urology and Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Ding-Wei
DW
Ye
Hai-Liang
HL
Zhang
Yao
Y
Zhu
Guo-Hai
GH
Shi
D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000150:complications / Q000628:therapy*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018288:Carcinoma, Small Cell / Q000097:blood / Q000150:complications / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D015653:Cystectomy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D000077143:Docetaxel; D004317:Doxorubicin / Q000008:administration & dosage; D053159:Dysuria / Q000209:etiology; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage; D014519:Ureterostomy; D001749:Urinary Bladder Neoplasms / Q000097:blood / Q000150:complications / Q000628:therapy*; D000093542:Gemcitabine
D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D007770:L-Lactate Dehydrogenase; D002945:Cisplatin; D000093542:Gemcitabine