Study The Diagnosis And Treatment Of Small Cell Carcinoma Of The Urinary Bladder

Background:Small cell carcinoma of the urinary bladder(SCCB)is a rare tumor with high malignant degree and poor prognosis,and there is no standard therapeutic strategy.Objectives:Discuss the treatment strategy of the SCCB by analyzing of the clinical feature,tumor character,treatment process and prognosis.Methods:A retrospective analysis of the the clinical feature,tumor character,treatment process and prognosis of patients with confirmed pathologically SCCB disease.With SPSS Statistics V19.0,log-rank tests were used to analyze the survival outcomes among different group,and Kaplan-Meier survival curves were plotted for the group.Results:All cases ranged in age of from 58 years to 84 years,the mean age is 71±10.116 years.The ratio of male-to-female is 12:1.The percentage of smokers is 46.15%.Of all cases,92.21%presented with hematuria,only 7.69%presented with dysuresia,urinary frequency and urgency.One case(7.69%)had T1 disease,five cases(38.46%)had T2 disease,five cases(38.46%)had T3 disease,two cases(15.38%)had T4 disease,and four cases(30.77%)had lymphatic metastasis disease.The anatomic stage,one case had stage ? disease,five cases had stage ? disease,three cases had stage ? disease,and four cases had stage ? disease.Tumor invaded trigone of bladder in two case(15.38%),and tumor invaded ureterostoma in two cases(15.38%).Of all cases' tumor(100%)is a broader base,cauliflower-like neoplasm,eight case(61.54%)had tumor satellite focus.Histologic findings indicated that,six patients(46.15%)had mixed SCC-TCC,seven patients(53.85%)had pure bladder SCC.Immunohistochemical findings indicated that,eleven cases(100%)had Syn positive,six cases(54.55%)had CgA positive,eight cases(72.73%)CD56 positive,six cases(54.55%)had CK positive,except two cases lack of immunohistochemical.Of all cases,nine patients(69.23%)had non-radical surgery combined with postoperative adjuvant systemic chemotherapy,and 1-year,3-year,5-year disease-specific survival rates were 88.89%,44.44%and 44.44%,respectively.Besides,stage ? tumor,1-year,3-year,5-year disease-specific survival rates were 100%,66.67%and 66.67%,respectively.Stage ? tumor,1-year,3-year disease-specific survival rates were 100%and 0,respectively.Stage IV tumor,1-year,3-year disease-specific survival rates were 50%.Conclusions:SCCB is an neuroendocrine tumor,which had high malignant degree and infiltrating growth at early stage.It's prognosis always is poor.Most cases of SCCB express neural markers,most commonly Syn,CgA and CD56.There was no significant difference between the overall survival of patients with pure SCC and patients with mixed SCC tumors,P=0.467.For non-locally advanced tumor,surgery combined with postoperative adjuvant systemic chemotherapy as the first choice.Besides radical cystectomy,the bladder-preserving operations is also a choice for patients with stage I or stage ? disease.There was no significant difference between the overall survival of patients undergo partial cystectomy and patients undergo TURBT or PVBT,P=0.833.