Clinical outcomes of patients with pure small cell carcinoma of the urinary bladder

  • Gokmen Umut ErdemEmail author
  • Mutlu Dogan
  • Aydin Aytekin
  • Suleyman Sahin
  • Havva Yeşil Cinkir
  • Abdullah Sakin
  • Melike Ozcelik
  • Oktay Bozkurt
  • Emel Sezer
  • Nebi Serkan Demirci
  • Yakup Bozkaya
  • Nurullah Zengin
Original Article



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.


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.


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.


Bladder Chemotherapy Neuroendocrine carcinoma Small cell carcinoma Surgery 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

No prospective studies with human participants or animals were performed by any of the authors for this article. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


  1. 1.
    Erdem GU, Ozdemir NY, Demirci NS et al (2016) Small cell carcinoma of the urinary bladder: changing trends in the current literature. Curr Med Res Opin 32(6):1013–1021. CrossRefPubMedGoogle Scholar
  2. 2.
    Cramer SF, Aikawa M, Cebelin M (1981) Neurosecretory granules in small cell invasive carcinoma of the urinary bladder. Cancer. 47(4):724–730CrossRefPubMedGoogle Scholar
  3. 3.
    Abrahams NA, Moran C, Reyes AO, Siefker-Radtke A, Ayala AG (2005) Small cell carcinoma of the bladder: a contemporary clinicopathological study of 51 cases. Histopathology. 46(1):57–63. CrossRefPubMedGoogle Scholar
  4. 4.
    Cheng L, Pan CX, Yang XJ, Lopez-Beltran A, MacLennan GT, Lin H, Kuzel TM, Papavero V, Tretiakova M, Nigro K, Koch MO, Eble JN (2004) Small cell carcinoma of the urinary bladder: a clinicopathologic analysis of 64 patients. Cancer. 101(5):957–962. CrossRefPubMedGoogle Scholar
  5. 5.
    Choong NW, Quevedo JF, Kaur JS (2005) Small cell carcinoma of the urinary bladder. The Mayo Clinic experience. Cancer. 103(6):1172–1178. CrossRefPubMedGoogle Scholar
  6. 6.
    Vakar-Lopez F, True LD (2007) How wide is the spectrum of neuroendocrine carcinoma of the urinary bladder? Am J Clin Pathol 128(5):723–725. CrossRefPubMedGoogle Scholar
  7. 7.
    Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL (2010) AJCC Cancer staging manual, 7th edn, pp 497–502Google Scholar
  8. 8.
    Ismaili N, Heudel PE, Elkarak F, Kaikani W, Bajard A, Ismaili M, Errihani H, Droz JP, Flechon A (2009) Outcome of recurrent and metastatic small cell carcinoma of the bladder. BMC Urol 9(4).
  9. 9.
    Pasquier D, Barney B, Sundar S, Poortmans P, Villa S, Nasrallah H, Boujelbene N, Ghadjar P, Lassen-Ramshad Y, Senkus E, Oar A, Roelandts M, Amichetti M, Vees H, Zilli T, Ozsahin M (2015) Small cell carcinoma of the urinary bladder: a retrospective, multicenter rare cancer network study of 107 patients. Int J Radiat Oncol Biol Phys 92(4):904–910. CrossRefPubMedGoogle Scholar
  10. 10.
    Chen Z, Liu Q, Chen R, Liu Z, Li M, Ling Q, Wu L, Yang J, Liu X, Wang T, Hu Z, Guo X, Wang S, Yang W, Liu J (2017) Clinical analysis of small cell carcinoma of the bladder in Chinese: nine case reports and literature reviews. World J Surg Oncol 15(1):33. CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Koay EJ, Teh BS, Paulino AC, Butler EB (2011) A surveillance, epidemiology, and end results analysis of small cell carcinoma of the bladder: epidemiology, prognostic variables, and treatment trends. Cancer. 117(23):5325–5333. CrossRefPubMedGoogle Scholar
  12. 12.
    Hou CP, Lin YH, Chen CL et al (2013) Clinical outcome of primary small cell carcinoma of the urinary bladder. Onco Targets Ther 6:1179–1185. CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Ploeg M, Aben KK, Hulsbergen-van de Kaa CA et al (2010) Clinical epidemiology of nonurothelial bladder cancer: analysis of the Netherlands Cancer Registry. J Urol 183(3):915–920. CrossRefPubMedGoogle Scholar
  14. 14.
    Bhatt VR, Loberiza FR Jr, Tandra P, Krishnamurthy J, Shrestha R, Wang J (2014) Risk factors, therapy and survival outcomes of small cell and large cell neuroendocrine carcinoma of urinary bladder. Rare Tumors 6(1):5043–5014. CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Balar A, Bajorin DF, Milowsky MI (2011) Management of invasive bladder cancer in patients who are not candidates for or decline cystectomy. Ther Adv Urol 3(3):107–117. CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Schreiber D, Rineer J, Weiss J, Leaf A, Karanikolas N, Rotman M, Schwartz D (2013) Characterization and outcomes of small cell carcinoma of the bladder using the surveillance, epidemiology, and end results database. Am J Clin Oncol 36(2):126–131. CrossRefPubMedGoogle Scholar
  17. 17.
    Patel SG, Stimson CJ, Zaid HB, Resnick MJ, Cookson MS, Barocas DA, Chang SS (2014) Locoregional small cell carcinoma of the bladder: clinical characteristics and treatment patterns. J Urol 191(2):329–334. CrossRefPubMedGoogle Scholar
  18. 18.
    Koay EJ, Teh BS, Paulino AC, Butler EB (2012) Treatment trends and outcomes of small-cell carcinoma of the bladder. Int J Radiat Oncol Biol Phys 83(1):64–70. CrossRefPubMedGoogle Scholar
  19. 19.
    Mattes MD, Kan CC, Dalbagni G, Zelefsky MJ, Kollmeier MA (2015) External beam radiation therapy for small cell carcinoma of the urinary bladder. Pract Radiat Oncol 5(1):e17–e22. CrossRefPubMedGoogle Scholar
  20. 20.
    Kaushik D, Frank I, Boorjian SA, Cheville JC, Eisenberg MS, Thapa P, Tarrell RF, Thompson RH (2015) Long-term results of radical cystectomy and role of adjuvant chemotherapy for small cell carcinoma of the bladder. Int J Urol 22(6):549–554. CrossRefPubMedGoogle Scholar
  21. 21.
    Quek ML, Nichols PW, Yamzon J et al (2005) Radical cystectomy for primary neuroendocrine tumors of the bladder: the university of southern California experience. J Urol 174(1):93–96. CrossRefPubMedGoogle Scholar
  22. 22.
    Siefker-Radtke AO, Dinney CP, Abrahams NA et al (2004) Evidence supporting preoperative chemotherapy for small cell carcinoma of the bladder: a retrospective review of the M. D. Anderson cancer experience. J Urol 172(2):481–484CrossRefPubMedGoogle Scholar
  23. 23.
    Siefker-Radtke AO, Kamat AM, Grossman HB, Williams DL, Qiao W, Thall PF, Dinney CP, Millikan RE (2009) Phase II clinical trial of neoadjuvant alternating doublet chemotherapy with ifosfamide/doxorubicin and etoposide/cisplatin in small-cell urothelial cancer. J Clin Oncol 27(16):2592–2597. CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Lynch SP, Shen Y, Kamat A, Grossman HB, Shah JB, Millikan RE, Dinney CP, Siefker-Radtke A (2013) Neoadjuvant chemotherapy in small cell urothelial cancer improves pathologic downstaging and long-term outcomes: results from a retrospective study at the MD Anderson Cancer Center. Eur Urol 64(2):307–313. CrossRefPubMedGoogle Scholar
  25. 25.
    Eswara JR, Heney NM, Wu CL, McDougal WS (2015) Long-term outcomes of organ preservation in patients with small cell carcinoma of the bladder. Urol Int 94(4):401–405. CrossRefPubMedGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2019

Authors and Affiliations

  • Gokmen Umut Erdem
    • 1
    Email author
  • Mutlu Dogan
    • 2
  • Aydin Aytekin
    • 3
  • Suleyman Sahin
    • 4
  • Havva Yeşil Cinkir
    • 5
  • Abdullah Sakin
    • 6
  • Melike Ozcelik
    • 7
  • Oktay Bozkurt
    • 8
  • Emel Sezer
    • 9
  • Nebi Serkan Demirci
    • 10
  • Yakup Bozkaya
    • 11
  • Nurullah Zengin
    • 2
  1. 1.Department of Medical OncologyKocaeli Derince Training and Research HospitalKocaeliTurkey
  2. 2.Department of Medical OncologyAnkara Numune Training and Research HospitalAnkaraTurkey
  3. 3.Department of Medical OncologyMedical Faculty of Gazi UniversityAnkaraTurkey
  4. 4.Department of Medical OncologyVan Training and Research HospitalVanTurkey
  5. 5.Department of Medical OncologyDr. Abdurrahman Yurtaslan Ankara Oncology Training and Research HospitalAnkaraTurkey
  6. 6.Department of Medical OncologyOkmeydani Training and Research HospitalİstanbulTurkey
  7. 7.Department of Medical OncologyKartal Training and Research HospitalİstanbulTurkey
  8. 8.Department of Medical OncologyMedical Faculty of Erciyes UniversityKayseriTurkey
  9. 9.Department of Medical OncologyMedical Faculty of Mersin UniversityMersinTurkey
  10. 10.Department of Medical OncologyTekirdag State HospitalTekirdagTurkey
  11. 11.Department of Medical OncologyEdirne State HospitalEdirneTurkey

Personalised recommendations