A Surveillance, Epidemiology, and End Results analysis of small cell carcinoma of the bladder

Epidemiology, prognostic variables, and treatment trends

Authors

  • Eugene J. Koay MD, PhD,

    1. Baylor College of Medicine, Houston, Texas
    2. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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  • Bin S. Teh MD,

    Corresponding author
    1. Department of Radiation Oncology, Methodist Hospital, Houston, Texas
    2. Department of Molecular Radiation Oncology, The Methodist Hospital Research Institute, Houston, Texas
    • The Methodist Hospital, 6565 Fannin Street, Houston, TX 77030
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    • Fax: (713) 441-4493

  • Arnold C. Paulino MD,

    1. Department of Radiation Oncology, Methodist Hospital, Houston, Texas
    2. Department of Molecular Radiation Oncology, The Methodist Hospital Research Institute, Houston, Texas
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  • E. Brian Butler MD

    1. Department of Radiation Oncology, Methodist Hospital, Houston, Texas
    2. Department of Molecular Radiation Oncology, The Methodist Hospital Research Institute, Houston, Texas
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  • Presented at the 51st Annual Meeting of the American Society for Radiation Oncology, Chicago, Illinois, October 31 to November 5, 2009.

Abstract

BACKGROUND:

Small cell carcinoma of the urinary bladder (SCCB) is difficult to characterize and study because of its rarity. For the current study, a large population-based database was used to address ill-defined clinical parameters for this disease.

METHODS:

The authors analyzed the incidence, sociodemographics, prognostic variables, and treatment trends of this cancer in the Surveillance, Epidemiology, and End Results (SEER) limited database (1991-2005). The SEER-Medicare database (1991-2005) was used to estimate chemotherapy use.

RESULTS:

There were 642 patients in the SEER limited dataset. From 1991 to 2005, the incidence of SCCB increased significantly from 0.05 to 0.14 cases per 100,000 population (P < .01; approximately 500 new cases of SCCB per year, representing 0.7% of all bladder malignancies). The median overall survival was 11 months. Elderly Caucasian men were the most commonly affected (ratio of Caucasians to non-Caucasians, 10:1; ratio of men to women, 3:1; median age, 73 years). Age, race, marital status, and TNM staging were identified as independent prognostic variables (P < .05). Patients who had stage IV disease without distant metastasis (ie, positive lymph node status) had overall and cancer-specific survival rates similar to those of patients who had stage I through III disease, but they had significantly better survival compared with patients who had distant metastasis (P < .0001). Transurethral resection of the bladder tumor became the most common surgical treatment (P < .0001), representing 55% of patients from 2001 to 2005. The receipt of radiation and chemotherapy did not change significantly during the study period.

CONCLUSIONS:

These comprehensive data delineated the patient population for this rare disease, described several independent prognostic variables, and demonstrated clear treatment trends for this disease. The results suggest that a simpler staging system (ie, limited stage vs extensive stage) may be appropriate for patients with SCCB. Cancer 2011;. © 2011 American Cancer Society.

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