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
5056 - Phase 2 study of 2 dosing regimens of cemiplimab, a human monoclonal anti–PD-1, in metastatic cutaneous squamous cell carcinoma (mCSCC)
Presenter: Danny Rischin
Session: Poster Display session 3
Resources:
Abstract
5710 - Avelumab for advanced Merkel cell carcinoma in the Netherlands; a nationwide survey
Presenter: Sonja Levy
Session: Poster Display session 3
Resources:
Abstract
3152 - Health-related quality of life in patients with metastatic Merkel cell carcinoma receiving second-line or later avelumab treatment: 36-month follow-up data
Presenter: Sandra D'Angelo
Session: Poster Display session 3
Resources:
Abstract
5715 - A Phase 2, Randomized Study of Nivolumab (NIVO) and Ipilimumab (IPI) versus NIVO, IPI and Stereotactic Body Radiation Therapy (SBRT) for Metastatic Merkel Cell Carcinoma (MCC, NCT03071406) – a preliminary report.
Presenter: Sungjune Kim
Session: Poster Display session 3
Resources:
Abstract
2854 - Real-world impact of immune checkpoint inhibitors in metastatic uveal melanoma
Presenter: Kalijn Bol
Session: Poster Display session 3
Resources:
Abstract
2928 - Immune checkpoint inhibitors in a cohort of 206 metastatic uveal melanomas patients
Presenter: Mathilde Saint-Ghislain
Session: Poster Display session 3
Resources:
Abstract
1235 - Incidence and survival of Uveal Melanoma occurring as single cancer versus its occurrence as a first or second primary neoplasm
Presenter: Ahmad Alfaar
Session: Poster Display session 3
Resources:
Abstract
3615 - Validation of a Clinicopathological and Gene Expression Profile (CP-GEP) Model for Sentinel Lymph Node Metastasis in Primary Cutaneous Melanoma
Presenter: Evalyn Mulder
Session: Poster Display session 3
Resources:
Abstract
1793 - External validation of the 8th Edition Melanoma Staging System of the American Joint Committee on Cancer (AJCC) using the Surveillance, Epidemiology and End Results (SEER) Program
Presenter: Angelina Tjokrowidjaja
Session: Poster Display session 3
Resources:
Abstract
4278 - Clinical factors and overall survival (OS) associated with patterns of metastases (mets) in melanoma patients (pts).
Presenter: Ines Pires da Silva
Session: Poster Display session 3
Resources:
Abstract