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
2743 - The Impact of Targeted Therapies and Immunotherapy in Melanoma Brain Metastases: a Systematic Review and Meta-Analysis
Presenter: Mario Mandala
Session: Poster Display session 3
Resources:
Abstract
5479 - Intracranial Anti-Tumor Activity in Melanoma Brain Metastases with Encorafenib Plus Binimetinib: A Multicenter, Retrospective Analysis
Presenter: Jose Lutzky
Session: Poster Display session 3
Resources:
Abstract
3560 - Outcomes of Patients with Melanoma Brain Metastases (MBM) Treated with Standard of Care Therapy After Being Excluded from MBM-Specific Clinical Trials
Presenter: Kourtney Holbrook
Session: Poster Display session 3
Resources:
Abstract
3175 - The analysis of current treatment outcomes in melanoma patients with brain metastases
Presenter: Joanna Placzke
Session: Poster Display session 3
Resources:
Abstract
4550 - A multivariate model to define prognostic groups among patients with melanoma brain metastases: a 10-year retrospective cohort study
Presenter: Giacomo Pelizzari
Session: Poster Display session 3
Resources:
Abstract
4191 - The immune landscape of melanoma significantly influences survival in patients with highly mutated tumors.
Presenter: Robert Ferguson
Session: Poster Display session 3
Resources:
Abstract
1625 - Final Results from Phase II of Combination with Canerpaturev (formerly HF10), an Oncolytic Viral Immunotherapy, and Ipilimumab in Unresectable or Metastatic Melanoma in 2nd-or later line treatment
Presenter: Kenji Yokota
Session: Poster Display session 3
Resources:
Abstract
5346 - Evaluating polygenic risk score prediction model for melanoma prognosis
Presenter: Miriam Potrony
Session: Poster Display session 3
Resources:
Abstract
5477 - Impact of sarcopenia in patients with metastatic melanoma treated with immunotherapy
Presenter: Maria Grazia Vitale
Session: Poster Display session 3
Resources:
Abstract
3469 - Ancillary evaluation of systemic immune antitumor response (SIAR) and tumor growth rate (TGR) of patients (pts) with metastatic melanoma (MM) treated with radiotherapy (RT) combined with ipilimumab (ipi) in the phase 1 study Mel-Ipi-Rx.
Presenter: Celine Boutros
Session: Poster Display session 3
Resources:
Abstract