Clinical features and prognosis of small cell carcinoma of the bladder: a single center retrospective analysis.

IF 1.9 3区医学 Q4 ANDROLOGY

Translational andrology and urology Pub Date : 2025-03-30 Epub Date: 2025-03-26 DOI:10.21037/tau-2024-645

Zhaoyang Sheng, Maoyu Wang, Yang Xu, Jinshan Xu, Chen Zhang, Hui Zhang, Jinpeng Zhu, Shuxiong Zeng, Chuanliang Xu, Zhensheng Zhang

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引用次数: 0

Abstract

Background: Small cell carcinoma of the bladder (SCCB) is a rare and aggressive subtype, usually diagnosed at advanced stages. Due to its rarity, the clinical features, prognostic factors, and treatment strategies are not well defined, and data on long-term outcomes are limited. This study aims to analyze the clinical characteristics, treatment options, and prognostic factors of SCCB to enhance clinical understanding and guide practice.

Methods: A retrospective analysis of 41 SCCB cases treated at Changhai Hospital between 2006 and 2023 was conducted. Clinical, pathological, and treatment data were collected. The median follow-up duration was calculated as 41.0 months [95% confidence interval (CI): 31.3-50.7] using the reverse Kaplan-Meier method. Overall survival (OS) rates were estimated using the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were used to identify prognostic factors.

Results: The median age was 71 years (range, 41-89 years). Pure SCCB accounted for 56.1% of cases, and 48.78% of tumors were located on the lateral bladder wall. Tumors ≥4 cm were found in 56.10% of cases. According to the tumor-node-metastasis (TNM) classification, 63.41% of patients underwent radical cystectomy, and 34.14% had lymph node or distant metastasis. None of the patients received neoadjuvant chemotherapy (NACT), while 41.03% underwent adjuvant chemotherapy post-surgery. The median OS was 30 months, with 1- and 3-year OS rates of 74.8% and 41.4%, respectively. Univariate analysis showed that T stage (P=0.002), lymph node metastasis (P<0.001), and distant metastasis (P<0.001) were associated with poor prognosis. Multivariate analysis confirmed T stage (P=0.04) and distant metastasis (P<0.001) as independent prognostic factors.

Conclusions: SCCB is often diagnosed at a late stage with gross hematuria as the most common symptom, Neoadjuvant therapy and immunotherapy can extend OS. T stage and distant metastasis are critical prognostic factors. Early diagnosis and intervention are crucial for improving outcomes.

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膀胱小细胞癌的临床特征与预后：单中心回顾性分析。

背景：膀胱小细胞癌（SCCB）是一种罕见的侵袭性亚型，通常在晚期诊断出来。由于其罕见性，临床特征、预后因素和治疗策略没有很好的定义，长期结果的数据有限。本研究旨在分析SCCB的临床特点、治疗方案及预后因素，以提高临床认识和指导实践。方法：对2006 ~ 2023年在长海医院收治的41例SCCB患者进行回顾性分析。收集临床、病理和治疗资料。采用反向Kaplan-Meier法计算中位随访时间为41.0个月[95%可信区间（CI）： 31.3-50.7]。使用Kaplan-Meier法估计总生存率（OS）。采用单因素和多因素Cox回归分析确定预后因素。结果：中位年龄71岁（范围41 ~ 89岁）。单纯SCCB占56.1%，48.78%肿瘤位于膀胱外侧壁。肿瘤≥4 cm者占56.10%。根据肿瘤-淋巴结-转移（TNM）分类，63.41%的患者行根治性膀胱切除术，34.14%的患者有淋巴结或远处转移。所有患者均未接受新辅助化疗（NACT）， 41.03%的患者术后接受了辅助化疗。中位生存期为30个月，1年和3年生存期分别为74.8%和41.4%。单因素分析显示T期（P=0.002），淋巴结转移（P=0.002）。结论：SCCB多诊断为晚期，以肉眼血尿为最常见症状，新辅助治疗和免疫治疗可延长OS。T分期和远处转移是重要的预后因素。早期诊断和干预对改善预后至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Translational andrology and urology Medicine-Urology

CiteScore

4.10

自引率

5.00%

发文量

期刊介绍： ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.