Abstract 1715
Background
Small cell bladder cancer (SCBC) is rare and accounts for <1% of all bladder carcinomas. It is aggressive and outcomes are poor due to early metastatic spread. Owing to its rarity, there is currently no standardised UK management pathway and treatments vary between institutions.
Methods
We conducted a retrospective analysis of all patients presenting with SCBC across 26 UK institutions between 1/1/2006 - 1/1/2016. We report on the patient characteristics, treatment received and clinical outcome. Data cut-off date is 1/2/2018.
Results
409 eligible patients (pts) from 26 UK institutions were identified. 75.1% were male. Median age was 71 years (range 35 - 96). 189/409 pts (46.2%) had pure small cell cancer. At data cut-off, 301/409 pts (73.6%) have died. Median overall survival (OS) was 15.9 months (range 9 - 4230 days). 200/409 pts (48.9%) presented with bladder only disease (N0 M0). Median OS of N0 M0 disease was 28.3 months vs. 12.7 months in N+/ M+ disease. Within the N0 M0 group, 61/200 pts (30.5%) had cystectomy and 104/200 pts (52.0%) had radiotherapy. The most common radiotherapy dose schedules used were 64Gy in 32 fractions and 55Gy in 20 fractions. Median OS of the cystectomy group was 26.7 months vs 30.0 months for radiotherapy. 247/409 pts (60.4%) received primary chemotherapy. Median time from diagnosis to first chemotherapy date was 47 days (range 5 - 124 days). The regimens used include carboplatin and etoposide (54.6%), cisplatin and etoposide (17.0%), cisplatin and gemcitabine (14.2%), carboplatin and gemcitabine (5.3%), other (3.6%). Median OS of pts who received primary chemotherapy was 21.6 months vs. 11.3 months in those who received no chemotherapy. Only 6 pts (1.5%) were identified to have brain metastases.
Conclusions
This is the largest retrospective study of unselected small cell cancer bladder population to date. These patients have a poor prognosis and brain metastases were rare (1.5%). Median OS was better in the chemotherapy than the non-chemotherapy group. Our results are in keeping with other studies which showed similar outcome between cystectomy and radiotherapy in patients with bladder only disease. UK national consensus guidelines are now being set up to standardise therapeutic approach for this rare disease entity.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3128 - Systemic bevacizumab for the treatment of recurrent respiratory papillomatosis: A retrospective analysis from an academic tertiary care center
Presenter: Sumita Trivedi
Session: Poster Display session 3
Resources:
Abstract
1242 - Monalizumab in combination with cetuximab in patients (pts) with recurrent or metastatic (R/M) head and neck cancer (SCCHN) previously treated or not with PD-(L)1 inhibitors (IO): 1-year survival data.
Presenter: Roger Cohen
Session: Poster Display session 3
Resources:
Abstract
4703 - Updated results of a phase II study evaluating accelerator-based boron neutron capture therapy (AB-BNCT) with borofalan(10B) (SPM-011) in recurrent squamous cell carcinoma (R-SCC-HN) and recurrent and locally advanced non-SCC (R/LA-nSCC-HN) of the head and neck
Presenter: Katsumi Hirose
Session: Poster Display session 3
Resources:
Abstract
3638 - Phase 3 KEYNOTE-048 Study of First-Line (1L) Pembrolizumab (P) for Recurrent/Metastatic (R/M) Head and Neck Squamous Cell Carcinoma (HNSCC): Asia vs Non-Asia Subgroup (subgrp) Analysis
Presenter: Makoto Tahara
Session: Poster Display session 3
Resources:
Abstract
2954 - Integrated data review evaluating safety, pharmacokinetics (PK) and immunogenicity of RM-1929 photoimmunotherapy (PIT) in subjects with locoregional, recurrent head and neck squamous cell carcinoma (rHNSCC).
Presenter: Jennifer Johnson
Session: Poster Display session 3
Resources:
Abstract
3629 - First line versus second line immunotherapy in recurrent/metastatic squamous cell carcinoma of the head and neck
Presenter: Caroline Even
Session: Poster Display session 3
Resources:
Abstract
767 - Sensitizing HRAS overexpressing head and neck squamous cell carcinoma (HNSCC) to chemotherapy
Presenter: Theodoros Rampias
Session: Poster Display session 3
Resources:
Abstract
4985 - A Single-Arm, Open-Label, Multicenter, Phase IIIb Clinical Trial with Nivolumab in Subjects with Recurrent or Metastatic Platinum-refractory Squamous Cell Carcinoma of the Head and Neck.
Presenter: Paolo Bossi
Session: Poster Display session 3
Resources:
Abstract
1564 - Long-term Results of Phase 2 Trial of Reduced Modified Clinical Target Volume in Low-risk Nasopharyngeal Carcinoma Treated with Intensity Modulated Radiotherapy
Presenter: Jingjing Miao
Session: Poster Display session 3
Resources:
Abstract
3356 - To compare two oral mucosa contouring methods in predicting acute oral mucocitis in nasopharyngeal carcinoma treated with helical tomotherapy
Presenter: Yuan-Yuan Chen
Session: Poster Display session 3
Resources:
Abstract