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Tlili G, Ammar H, Majdoub W, Dziri S, Farhat W, Acacha E, Gupta R, Jalleli N, Azzabi A, Jaidane M. Paraplegia due to medullary compression caused by a large cell neuroendocrine carcinoma of the urinary bladder: A case report. Ann Med Surg (Lond) 2021; 67:102475. [PMID: 34188905 PMCID: PMC8220165 DOI: 10.1016/j.amsu.2021.102475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/30/2021] [Accepted: 06/04/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Neuroendocrine carcinomas of the urinary bladder are rare tumors, estimated at less than 1% of urinary bladder malignancies. They are mainly represented by small cell neuroendocrine carcinoma, while large cell neuroendocrine carcinoma (LCNEC) is rarely reported. CASE PRESENTATION We report a case of a 49-year-old man presenting paraplegia caused by a metastatic urinary bladder LCNEC, which was managed with palliative external beam radiotherapy (EBRT) associated with MVAC chemotherapy, including methotrexate, vinblastine sulfate, doxorubicin hydrochloride (Adriamycin), and cisplatin. At the last follow-up of one year after his admission, there was a symptomatic improvement in the pain intensity. CONCLUSION LCNEC of the bladder was first described in 1986, and, until now, less than 40 cases have been published in the literature. To the best of our knowledge, this is the first case of primary LCNEC of the urinary bladder presenting with paraplegia.
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Affiliation(s)
- Ghassen Tlili
- Department of Urology, Sahloul Hospital, Sousse, Tunisia
| | - Houssem Ammar
- Department of Gastrointestinal Surgery, Sahloul Hospital, Sousse, Tunisia
| | - Wiem Majdoub
- Department of Anatomopathology, Sahloul Hospital, Sousse, Tunisia
| | - Sonia Dziri
- Department of Nephrology, Sahloul Hospital, Sousse, Tunisia
| | - Waad Farhat
- Department of Gastrointestinal Surgery, Sahloul Hospital, Sousse, Tunisia
| | - Emir Acacha
- Department of Urology, Sahloul Hospital, Sousse, Tunisia
| | - Rahul Gupta
- Department of Gastrointestinal Surgery, Synergy Institute of Medical Sciences, Dehradun, India
| | | | - Awatef Azzabi
- Department of Nephrology, Sahloul Hospital, Sousse, Tunisia
| | - Mehdi Jaidane
- Department of Urology, Sahloul Hospital, Sousse, Tunisia
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Xia K, Zhong W, Chen J, Lai Y, Huang G, Liu H, Dong W, He W, Lin T, Huang J. Clinical Characteristics, Treatment Strategy, and Outcomes of Primary Large Cell Neuroendocrine Carcinoma of the Bladder: A Case Report and Systematic Review of the Literature. Front Oncol 2020; 10:1291. [PMID: 32850401 PMCID: PMC7399333 DOI: 10.3389/fonc.2020.01291] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/22/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose: The aim of this study was to review the clinicopathologic characteristics, treatments, and outcomes of patients with primary large cell neuroendocrine carcinoma of the bladder (LCNEC). Patients and Methods: We report one patient diagnosed with primary pure LCNEC of the bladder in Sun Yat-sen Memorial Hospital. In addition, we performed a systematic literature review, in April 2020, on case report and case series of LCNEC of the bladder. The clinicopathologic characteristics, treatments and outcomes of this rare disease were analyzed. Results: A total of 39 patients were included in our analysis (1 case from our institution and 38 cases from the literature). Most patients (79.5%) were male. The average age at the surgery for the patients is 61.5 years (range 19–85 years). The most common symptom was hematuria (n = 20, 76.9%). Almost all patients (38, 97.4%) underwent surgery, with 26 (66.7%) receiving multimodality therapy. Out of 24 patients with available data, regional or distant recurrences developed in 14 patients (58.3%). The median overall survival of the patients was 11.5 months, with 1- and 3-year survival rates of 54.0 and 21.4%, respectively. In the survival analysis, theT1–2 tumors (P = 0.025), no distant metastases at diagnosis (P = 0.001), and multimodality therapy (P = 0.017) were associated with better overall survival (OS). Conclusions: LCNEC of the bladder is an extremely rare neoplasm. The available data suggest that the disease has an aggressive natural history with poor prognosis. Early pathologic stage and multimodality treatment may be important factors in determining prognosis.
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Affiliation(s)
- Kun Xia
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wenlong Zhong
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Junyu Chen
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yiming Lai
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guohui Huang
- Department of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hao Liu
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wen Dong
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wang He
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tianxin Lin
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jian Huang
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Erdem GU, Dogan M, Aytekin A, Sahin S, Cinkir HY, Sakin A, Ozcelik M, Bozkurt O, Sezer E, Demirci NS, Bozkaya Y, Zengin N. Clinical outcomes of patients with pure small cell carcinoma of the urinary bladder. Ir J Med Sci 2019; 189:431-438. [PMID: 31463895 DOI: 10.1007/s11845-019-02074-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 07/24/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES There is not yet a standardized approach to treat patients with small cell carcinoma of the bladder (SmCCB). This study aims to investigate the clinical features, treatment, and survival outcomes of patients with pure SmCCB. MATERIALS AND METHODS Patients diagnosed with SmCCB between January 2006 and September 2015 were retrospectively evaluated. RESULTS A total of 34 patients with a median age of 63.0 years were included in the study, with a male to female ratio of 4.6:1.0. At the time of diagnosis, 22 patients (64.7%) had stage IV disease. At a median follow-up time of 12.7 months, 67.6% of patients died of bladder carcinoma, with an overall survival (OS) of 15.7 months for all patients. In the patients with stages I-III, nodal involvement, and distant metastases, the median OS was 31.8, 15.7, and 8.4 months, respectively (P = 0.005). Considering the survival rates of the patients (stages I-III) treated with surgery vs. local therapy, there was not a statistically significant difference (26.6 months and 31.8 months, P = 0.97, respectively). A multivariate analysis revealed that stage IV disease and poor ECOG performance status were associated with OS. CONCLUSION The optimal treatment of SmCCB has been under debate. For the patients with advanced stage of disease (T4b, N+, M+), platinum containing chemotherapeutic agents should be preferred. Stage IV disease and poor ECOG performance status were associated with shorter OS.
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Affiliation(s)
- Gokmen Umut Erdem
- Department of Medical Oncology, Kocaeli Derince Training and Research Hospital, 41310, Kocaeli, Turkey.
| | - Mutlu Dogan
- Department of Medical Oncology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Aydin Aytekin
- Department of Medical Oncology, Medical Faculty of Gazi University, Ankara, Turkey
| | - Suleyman Sahin
- Department of Medical Oncology, Van Training and Research Hospital, Van, Turkey
| | - Havva Yeşil Cinkir
- Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Abdullah Sakin
- Department of Medical Oncology, Okmeydani Training and Research Hospital, İstanbul, Turkey
| | - Melike Ozcelik
- Department of Medical Oncology, Kartal Training and Research Hospital, İstanbul, Turkey
| | - Oktay Bozkurt
- Department of Medical Oncology, Medical Faculty of Erciyes University, Kayseri, Turkey
| | - Emel Sezer
- Department of Medical Oncology, Medical Faculty of Mersin University, Mersin, Turkey
| | | | - Yakup Bozkaya
- Department of Medical Oncology, Edirne State Hospital, Edirne, Turkey
| | - Nurullah Zengin
- Department of Medical Oncology, Ankara Numune Training and Research Hospital, Ankara, Turkey
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Metastatic Small Cell Carcinoma of the Urinary Bladder That Recurred in the Vagina 6 Years after Radical Cystectomy: A Case Report. Case Rep Urol 2018; 2018:3069294. [PMID: 30473902 PMCID: PMC6220397 DOI: 10.1155/2018/3069294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/03/2018] [Accepted: 10/09/2018] [Indexed: 11/17/2022] Open
Abstract
Small cell carcinoma (SCC) of the urinary bladder is highly aggressive and portends a poor outcome. Herein, we report a patient with recurrent SCC of the urinary bladder who experienced an unusually long-term disease-free duration after radical cystectomy. The patient was a 60-year-old woman who had undergone transurethral resection followed by radical cystectomy for muscle-invasive bladder cancer (high-grade urothelial carcinoma with adenocarcinomatous differentiation) 6 years prior; the surgical specimen had a negative surgical margin. She was referred to our hospital because of continuous bleeding from her vagina. Magnetic resonance imaging showed a mass located at the anterior wall of her residual vagina, a biopsy of which confirmed a pathological diagnosis of adenocarcinoma. The vaginal tumor and a section of the sigmoid colon were resected en bloc and were pathologically diagnosed as adenocarcinoma and SCC. We reevaluated the initial transurethral resection specimen and found SCC with foci of adenocarcinoma concomitant with high-grade urothelial carcinoma. Local recurrence and metastasis at the pelvic bone occurred 4 months later; although radiation therapy was performed, she died of the progressive disease.
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Niu Q, Lu Y, Xu S, Shi Q, Guo B, Guo Z, Huang T, Wu Y, Yu J. Clinicopathological characteristics and survival outcomes of bladder neuroendocrine carcinomas: a population-based study. Cancer Manag Res 2018; 10:4479-4489. [PMID: 30349380 PMCID: PMC6190820 DOI: 10.2147/cmar.s175286] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Bladder neuroendocrine carcinomas (BNECs) are relatively a rare type of tumor. The aim of this study was to examine the clinicopathological characteristics and predictors of survival outcomes of patients with BNECs based on the analysis of the national Surveillance, Epidemiology, and End Results (SEER) database. Materials and methods Kaplan-Meier analysis with log-rank test was used for survival comparisons. Multivariate Cox regression model was employed to analyze the effect of different treatments on overall survival (OS) and cancer-specific survival (CSS). Results A total of 910 patients were identified between 2004 and 2014. Overall, 648 (71.2%) patients had small cell neuroendocrine carcinoma (SCNEC), 35 (3.8%) had large cell neuroendocrine carcinoma (LCNEC), 10 (1.1%) had carcinoid tumor (well-differentiated neuroendocrine tumor), 16 (1.8%) had paraganglioma/pheochromocytoma (PGL/PHEO), 619 (68.0%) had a poorly differentiated or undifferentiated histology grade, 214 (23.5%) presented with metastatic disease, 586 (64.4%) underwent transurethral ablation/destruction for bladder tumor, and 245 (26.9%) had partial/total cystectomy. Cystectomy+chemotherapy+radiotherapy (CCR) has the highest long-term survival rate among various treatments. The 1-, 3-, and 5-years CSS of CCR were 56%, 56%, and 56%, respectively. By using multivariable Cox proportional hazard model, age, histology, N stage, SEER stage, tumor size, radiotherapy, chemotherapy, and local treatment of the primary site were identified as independent predictors for OS and CSS; all P<0.05. Conclusion In BNEC, SCNEC has an absolute advantage in number. SCNEC/LCNEC tend to be older men. PGL/PHEO and carcinoid tumors have younger mean ages, earlier tumor stages, and better prognosis than SCNEC/LCNEC. Surgery, radiotherapy and chemotherapy are better than conservative treatment. However, whatever cystectomy or bladder sparing, chemotherapy should be a major component of treatment.
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Affiliation(s)
- Quan Niu
- Department of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Youyi Lu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, People's Republic of China
| | - Shigao Xu
- Department of Urology, Subei People's Hospital of Jiangsu Province (Clinical Medical College, Yangzhou University), Yangzhou, Jiangsu, People's Republic of China,
| | - Qun Shi
- Department of Urology, Subei People's Hospital of Jiangsu Province (Clinical Medical College, Yangzhou University), Yangzhou, Jiangsu, People's Republic of China,
| | - Baoyu Guo
- Department of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Zhe Guo
- Department of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Tianbao Huang
- Department of Urology, Subei People's Hospital of Jiangsu Province (Clinical Medical College, Yangzhou University), Yangzhou, Jiangsu, People's Republic of China,
| | - Yinxia Wu
- Department of Oncology, Subei People's Hospital of Jiangsu Province (Clinical Medical College, Yangzhou University), Yangzhou, Jiangsu, People's Republic of China,
| | - Junjie Yu
- Department of Urology, Subei People's Hospital of Jiangsu Province (Clinical Medical College, Yangzhou University), Yangzhou, Jiangsu, People's Republic of China,
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Xiao GQ, Barrett MM, Yang Q, Unger PD. Clinicopathologic and Immunohistochemical Study of Combined Small Cell Carcinoma and Urothelial Carcinoma Molecular Subtype. Pathol Oncol Res 2017; 25:889-895. [PMID: 29249035 DOI: 10.1007/s12253-017-0369-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 11/29/2017] [Indexed: 10/18/2022]
Abstract
Muscle invasive bladder cancer, an aggressive disease with heterogeneous molecular profiles, has recently been subclassified into three major molecular subtypes -basal, luminal and "p53-like" urothelial carcinomas (UCas), which bear prognostic and therapeutic implication. Similar to breast cancer, basal and luminal subtype UCas are designated by basal (CK5/14) and luminal (CK20) markers. The "p53-like" subtype presents with wild-type p53 gene with upregulated p53 pathways and is implicated in chemoresistance. Urinary bladder is one of the most common primary sites of extrapulmonary small cell carcinoma (SmCC). Bladder SmCC frequently coexists with UCa; however, the relation of SmCC with specific UCa molecular subtypes has not been studied. The aim of this study is to investigate the clinicopathology and immunophenotypes of the combined SmCC and UCa molecular subtypes. A total of 22 combined SmCC and UCa cases were studied for the clinicopathology and immunohistochemical (IHC) profiles by luminal and basal cell markers as well as Her2/Neu and p53. Our results demonstrated that all the urinary bladder SmCCs were associated with high grade UCas. They were more commonly seen in older male patients with a smoking history and had a poor prognosis. Based on the reported molecular subtyping, the UCas could be immunohistochemically subclassified into luminal, basal, dual and null types, which showed different clinicopathologic and IHC features. Compared to non-SmCC associated UCa, the subtypes of UCa in the combined SmCCs and UCas were characterized by: 1) Although overall luminal type was still relatively more common in men, basal marker-expressing subtypes were significantly increased in incidence and were more common in women. 2) Her2/Neu overexpression was more commonly observed in luminal than basal cell marker-expressing UCas. 3) IHC overexpression of p53 was common in all the subtypes, with UCas and SmCCs sharing the same p53 expression pattern. Although limited by relatively a small number of cases, the results of this study will enhance our understanding of the combined SmCC and UCa entity and potentially lead to a future therapeutic management.
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Affiliation(s)
- Guang-Qian Xiao
- Department of Pathology, Keck Medical Center, University of Southern California, 1500 San Pablo Street, Los Angeles, CA, 90033, USA.
| | - Mary M Barrett
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA
| | - Qi Yang
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA
| | - Pamela D Unger
- Department of Pathology, Lenox Hill Hospital-Northwell Health System, New York, NY, USA
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Ono A, Hirasawa Y, Yamashina M, Kaburagi N, Mima T, Sugihara T, Hamada R, Gondo T, Ohori M, Nagao T, Ohno Y. A Case of Primary Small-Cell Carcinoma of the Bladder. Case Rep Oncol 2016; 9:574-579. [PMID: 27920687 PMCID: PMC5118827 DOI: 10.1159/000450597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 09/02/2016] [Indexed: 12/11/2022] Open
Abstract
Primary small-cell carcinoma arising from the bladder (SmCCB) is uncommon. It differs from urothelial carcinoma (UC), the most common type of bladder cancer, with respect to its cell of origin, biology, and prognosis. Biologically, prostatic SmCCB is much more aggressive than UC, and the prognosis for cases with distant metastasis is especially poor. We report here a case of primary SmCCB (cT3bN1M0) treated with radical cystectomy.
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Affiliation(s)
- Ashita Ono
- Department of Urology, Akabane Central General Hospital, Tokyo, Japan
| | - Yosuke Hirasawa
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | | | - Naoto Kaburagi
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Takashi Mima
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Toru Sugihara
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Riu Hamada
- Department of Urology, Akabane Central General Hospital, Tokyo, Japan
| | - Tatsuo Gondo
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Makoto Ohori
- Department of Urology, Tokyo Medical University, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Yoshio Ohno
- Department of Urology, Tokyo Medical University, Tokyo, Japan
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Kouba E, Cheng L. Neuroendocrine Tumors of the Urinary Bladder According to the 2016 World Health Organization Classification: Molecular and Clinical Characteristics. Endocr Pathol 2016; 27:188-99. [PMID: 27334654 DOI: 10.1007/s12022-016-9444-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Neuroendocrine neoplasms of the urinary bladder are a rare type of tumor that account for a small percentage of urinary bladder neoplasms. These tumors of the urinary bladder range from well-differentiated neuroendocrine neoplasms (carcinoids) to the more aggressive subtypes such as small cell carcinoma. Despite the rarity of the neuroendocrine tumors of the bladder, there has been substantial investigation into the underlying genomic, molecular, and the cellular alterations within this group of neoplasms. Accordingly, these findings are increasingly incorporated into the understanding of clinical aspects of these neoplasms. In this review, we provide an overview of recent literature related to the 2016 World Health Organization Classification of Neuroendocrine Tumors of the Urinary Bladder. Particular emphasis is placed on molecular alterations and recently described gene expression. The neuroendocrine tumors of the urinary bladder are subdivided into four subtypes. Similar to their pulmonary and other extrapulmonary site counterparts, these have different degrees of neuroendocrine differentiation and morphological features. The clinical aspects of four subtypes of neuroendocrine tumor are discussed with emphasis of the most recent developments in diagnosis, treatment, and prognosis. An understanding of molecular basis of neuroendocrine tumors will provide a base of knowledge for future investigations into this group of unusual bladder neoplasms.
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Affiliation(s)
- Erik Kouba
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, 350 West 11th Street, IUHPL Room 4010, Indianapolis, IN, 46202, USA
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, 350 West 11th Street, IUHPL Room 4010, Indianapolis, IN, 46202, USA.
- Department of Urology, Indiana University School of Medicine, Indianapolis, USA.
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Small cell carcinoma of the urinary bladder without gross hematuria: a case report. Front Med 2015; 9:384-7. [PMID: 26271292 DOI: 10.1007/s11684-015-0405-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 05/11/2015] [Indexed: 10/23/2022]
Abstract
Small cell carcinoma of the urinary bladder (SCCB) is a rare and aggressive form of bladder cancer with poor prognosis. Hematuria is the main symptom of this malignancy, and most patients have a history of smoking. The disease incidence of malignant bladder tumors in China is approximately 0.74%. Early and accurate diagnosis of SCCB can ensure timely and appropriate treatment of this malignant disease. Oncologic surgery is the standard treatment; however, it may not be a curative approach. Chemotherapy and/or radiotherapy should be performed following surgical removal. This case report describes a patient with a single neoplasm diagnosed as SCCB that arose because of recurrence of bladder cancer after bladder tumor resection. In contrast to previously reported cases, this patient had no gross hematuria and no history of smoking.
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Arslan B, Bozkurt IH, Yonguc T, Vardar E, Degirmenci T, Kozacioglu Z, Gunlusoy B, Minareci S. Clinical features and outcomes of nontransitional cell carcinomas of the urinary bladder: Analysis of 125 cases. Urol Ann 2015; 7:177-82. [PMID: 25838209 PMCID: PMC4374255 DOI: 10.4103/0974-7796.150533] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 06/24/2014] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES The aim was to evaluate pathologic diagnosis, treatment and prognosis of 125 patients with nontransitional cell carcinoma of the urinary bladder. MATERIALS AND METHODS A total of 3590 patients with bladder tumors operated in our clinic between September 1998 and May 2013 were retrospectively evaluated. A total of 125 patients (107 men and 18 women) with nontransitional cell bladder cancer, confirmed by histopathology, were included in this study. The patients' characteristics, including age, gender, smoking history, tumor size, and localization, histological types, pathological tumor stages, treatment modalities, and survival rates were all recorded. RESULTS Of these tumors, 47 (37.6%) were adenocarcinoma (AC), 42 (33.6%) were squamous cell carcinoma (SCC), 23 (18.4%) were undifferentiated carcinoma (UC), 13 (10.4%) were other types of bladder carcinoma. Sixty-three (50.4%) patients had undergone radical cystectomy and pelvic lymphadenectomy ± adjuvant treatment (chemotherapy [CT]/radiotherapy) and 52 (41.6%) patients received radiotherapy ± CT. The median survival time of patients with AC and SCC were significantly higher than patients with UC (AC vs UC, P = 0.001; SCC vs UC, P = 0.000; AC vs. SCC, P = 0.219). Median survival time was significantly higher in radical cystectomy ± adjuvant treatment group (P < 0.05) in all histological types. CONCLUSION Prognosis of urinary bladder tumors was directly related to histological type and stage of the tumor. CT or radiotherapy has limited response rates. Early radical cystectomy should be performed to improve prognosis.
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Affiliation(s)
- Burak Arslan
- Department of Urology, Izmir Bozyaka Training and Research Hospital, Bozyaka, Izmir, Turkey
| | - Ibrahim Halil Bozkurt
- Department of Urology, Izmir Bozyaka Training and Research Hospital, Bozyaka, Izmir, Turkey
| | - Tarik Yonguc
- Department of Urology, Izmir Bozyaka Training and Research Hospital, Bozyaka, Izmir, Turkey
| | - Enver Vardar
- Department of Urology, Izmir Bozyaka Training and Research Hospital, Bozyaka, Izmir, Turkey
| | - Tansu Degirmenci
- Department of Urology, Izmir Bozyaka Training and Research Hospital, Bozyaka, Izmir, Turkey
| | - Zafer Kozacioglu
- Department of Urology, Izmir Bozyaka Training and Research Hospital, Bozyaka, Izmir, Turkey
| | - Bulent Gunlusoy
- Department of Urology, Izmir Bozyaka Training and Research Hospital, Bozyaka, Izmir, Turkey
| | - Suleyman Minareci
- Department of Urology, Izmir Bozyaka Training and Research Hospital, Bozyaka, Izmir, Turkey
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Shao IH, Lin YH, Hou CP, Juang HH, Chen CL, Chang PL, Tsui KH. Risk factors associated with ineligibility of adjuvant cisplatin-based chemotherapy after nephroureterectomy. DRUG DESIGN DEVELOPMENT AND THERAPY 2014; 8:1985-90. [PMID: 25364228 PMCID: PMC4211848 DOI: 10.2147/dddt.s72197] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE Radical nephroureterectomy (RNU) is a standard treatment for upper urinary tract urothelial carcinoma. However, RNU can result in decreased renal function and cannot be treated with adjuvant chemotherapy. We performed a risk group stratification analysis to determine the preoperative factors that are predictive of diminished renal function after RNU. MATERIALS AND METHODS We retrospectively evaluated the medical records of all patients who underwent nephroureterectomy for upper urinary tract urothelial carcinoma at the Chang Gung Memorial Hospital from 2001 to 2008. We analyzed the association between perioperative glomerular filtration rate and preoperative parameters including cancer characteristics, serum creatinine level, and kidney size measured on computed tomographic images. RESULTS A total of 242 patients fulfilled the inclusion criteria. The average decrease in renal function 1 month after RNU was 19.7%. Using 60 mL/min/1.73 m(2) as the eligibility cutoff for cisplatin-based chemotherapy, 42.1% of the population was eligible prior to nephroureterectomy, whereas following surgery only 15.2% remained eligible. Using a cutoff of 45 mL/min/1.73 m(2), 59.9% of the cohort was eligible for fractionated cisplatin dosing preoperatively, whereas only 32.6% remained above the cutoff postoperatively. The most significant predictors of poor postoperative renal function were body mass index >25 kg/m(2), age >65 years, contralateral kidney length less than 10 cm, and absence of ipsilateral hydronephrosis. CONCLUSION Our results suggest that older age, higher body mass index, smaller contralateral renal length, and absence of ipsilateral hydronephrosis are predictive of decreased renal function after RNU.
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Affiliation(s)
- I-Hung Shao
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taiwan, Republic of China ; Department of Urology, Lotung Poh-Ai Hospital, Chang Gung University, Taiwan, Republic of China
| | - Yu-Hsiang Lin
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taiwan, Republic of China
| | - Chen-Pang Hou
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taiwan, Republic of China
| | - Horng-Heng Juang
- Department of Anatomy, Chang Gung University, Taiwan, Republic of China ; Bioinformation Center, Chang Gung Memory Hospital, Kwei-Shan, Tao-Yuan, Taiwan, Republic of China
| | - Chien-Lun Chen
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taiwan, Republic of China
| | - Phei-Lang Chang
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taiwan, Republic of China ; Bioinformation Center, Chang Gung Memory Hospital, Kwei-Shan, Tao-Yuan, Taiwan, Republic of China
| | - Ke-Hung Tsui
- Department of Urology, Chang Gung Memorial Hospital at Linkou, Chang Gung University, Taiwan, Republic of China ; Bioinformation Center, Chang Gung Memory Hospital, Kwei-Shan, Tao-Yuan, Taiwan, Republic of China
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