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Liu L, Zhang P, Xiao Y, Wang Q, Zheng J. Prognostic Factors Influencing Postoperative Survival in Patients With Neuroendocrine Carcinoma of the Bladder: A Population-Based Study. Cancer Med 2025; 14:e70758. [PMID: 40062660 PMCID: PMC11891926 DOI: 10.1002/cam4.70758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 12/11/2024] [Accepted: 03/01/2025] [Indexed: 05/12/2025] Open
Abstract
BACKGROUND This study aimed to identify prognostic factors influencing survival in patients with bladder neuroendocrine carcinoma (NC). METHODS This study utilized the Surveillance, Epidemiology, and End Results (SEER) database (2004-2015) to compare NC with urothelial carcinoma (UC). We evaluated the prognostic value of clinicopathological characteristics and survival outcomes for bladder NC patients. Multivariable Cox proportional hazard models and propensity score matching (PSM) were employed for analysis. RESULT A total of 99,704 patients were included, with 603 in the NC group and 99,101 in the UC group. Compared with the UC group, the NC group was inclined to receive radical cystectomy (34.2% vs. 12.2%), radiation (25.0% vs. 4.6%) and chemotherapy (62.0% vs. 22.2%) as treatment options. Multivariate Cox regression analysis revealed higher overall survival (OS) and cancer-specific survival (CSS) outcomes for NC patients who underwent radical cystectomy (HR = 0.569, 95% CI = 0.537-0.603, p < 0.001; HR = 0.531, 95% CI = 0.489-0.577, p < 0.001; respectively). To mitigate bias, a 1:1 propensity score-matched analysis was performed on both groups, resulting in 1202 patients (n = 601 per group). Multivariate Cox regression analysis identified seven risk factors for OS and CSS: age at diagnosis, race, cT stage, cN stage, cM stage, histological type, and chemotherapy. Additionally, surgery of the primary site was a prognostic factor for OS. A better prognosis was observed for NC patients who underwent radical cystectomy compared to those who did not. NC patients who only received radical cystectomy have a better prognosis in both OS (log-rank p = 0.002) and CSS (log-rank p = 0.009) compared with those who only received radiotherapy. CONCLUSION Age, race, TNM stage, chemotherapy, and surgery were identified as independent predictors of bladder NC patients. Radical cystectomy may represent the optimal therapeutic approach to improve the prognosis of NC patients.
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Affiliation(s)
- Liang Liu
- Department of Urology, Key Laboratory of Molecular Pathology and Early Diagnosis of Tumor in Hebei Province, Prostate & Andrology Key Laboratory of BaodingBaoding No. 1 Central HospitalBaodingChina
| | - Pan‐Ying Zhang
- Department of UrologyHebei General HospitalShijiazhuangChina
| | - Yu Xiao
- Psychosomatic Medical Center, The Fourth People's Hospital of ChengduChengduChina
- Psychosomatic Medical Center, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroinformationUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Qiang Wang
- Department of Urology, Key Laboratory of Molecular Pathology and Early Diagnosis of Tumor in Hebei Province, Prostate & Andrology Key Laboratory of BaodingBaoding No. 1 Central HospitalBaodingChina
| | - Ji Zheng
- Department of Urology, Urologic Surgery CenterXinqiao Hospital, Third Military Medical University (Army Medical University)ChongqingChina
- State Key Laboratory of Trauma and Chemical PoisoningThird Military Medical University (Army Medical University)ChongqingChina
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2
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Bakaloudi DR, Koehne EL, Diamantopoulos LN, Holt SK, Sekar RR, Ghali F, Vakar-Lopez F, Nyame YA, Psutka SP, Gore JL, de la Calle CM, Lin DW, Schade GR, Liao JJ, Hsieh AC, Yezefski T, Hawley JE, Yu EY, Montgomery RB, Grivas P, Wright JL. Small Cell Bladder Cancer: Treatment Patterns for Local Disease and Associated Outcomes. A Retrospective Cohort Study. Clin Genitourin Cancer 2024; 22:102208. [PMID: 39265260 DOI: 10.1016/j.clgc.2024.102208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 08/12/2024] [Accepted: 08/13/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Small cell bladder cancer (SCBC) is a rare histologic subtype with relative paucity of data regarding treatment response and outcomes. We reviewed 2 databases to compare outcomes in patients with localized SCBC treated with cystectomy versus concurrent chemoradiotherapy (CCRT). We hypothesized that survival would be similar with these therapy approaches. METHODS We retrospectively reviewed our institutional and SEER-Medicare databases to identify patients with SCBC. Overall survival (OS) was determined from the date of diagnosis to last follow-up/death. For those with nonmetastatic disease, a multivariate Cox analysis was used to compare locoregional therapy with neoadjuvant chemotherapy (NAC) + cystectomy versus CCRT. RESULTS We identified 53 patients in our institutional database and 1166 patients in SEER-Medicare with localized SCBC. Median OS (mOS) with NAC + cystectomy was 46 months (95% CI, 21-72) and 45 months (95% CI, 0-104) in the institutional and SEER-Medicare databases, respectively, whereas mOS with CCRT was 26 months (95% CI, 5-47) and 23 months (95% CI, 18-28) in the 2 series, respectively. In multivariate analysis, NAC followed by cystectomy was associated with an approximately 30% reduction in mortality compared to CCRT in both institutional and national databases but did not reach statistical significance (Institution HR 0.71, 95% CI, 0.22-2.4, P = .58; SEER HR 0.73, 95% CI, 0.49-1.08; P = .11). CONCLUSIONS SCBC is very aggressive with limited survival observed in our institutional and SEER-Medicare datasets regardless of locoregional therapy used. There is an unmet need to define the optimal locoregional therapy for nonmetastatic stage and identify novel therapeutic targets.
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Affiliation(s)
| | | | | | - Sarah K Holt
- Department of Urology, University of Washington, Seattle, WA
| | - Rishi R Sekar
- Department of Urology, University of Michigan, Michigan, MI
| | - Fady Ghali
- Department of Urology, Yale School of Medicine, New Haven, CT
| | | | - Yaw A Nyame
- Department of Urology, University of Washington, Seattle, WA
| | - Sarah P Psutka
- Department of Urology, University of Washington, Seattle, WA
| | - John L Gore
- Department of Urology, University of Washington, Seattle, WA; Division of Clinical Research Fred Hutchinson Cancer Center, Seattle, WA
| | - Claire M de la Calle
- Department of Urology, University of Washington, Seattle, WA; Division of Clinical Research Fred Hutchinson Cancer Center, Seattle, WA
| | - Daniel W Lin
- Department of Urology, University of Washington, Seattle, WA; Division of Clinical Research Fred Hutchinson Cancer Center, Seattle, WA
| | - George R Schade
- Department of Urology, University of Washington, Seattle, WA; Division of Clinical Research Fred Hutchinson Cancer Center, Seattle, WA
| | - Jay J Liao
- Department of Radiation Oncology, University of Washington, Seattle, WA
| | - Andrew C Hsieh
- Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WA; Division of Human Biology, Fred Hutchinson Cancer Center, Seattle, WA
| | - Todd Yezefski
- Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WA
| | - Jessica E Hawley
- Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WA; Division of Clinical Research Fred Hutchinson Cancer Center, Seattle, WA
| | - Evan Y Yu
- Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WA; Division of Clinical Research Fred Hutchinson Cancer Center, Seattle, WA
| | - R Bruce Montgomery
- Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WA; Division of Clinical Research Fred Hutchinson Cancer Center, Seattle, WA
| | - Petros Grivas
- Division of Hematology and Oncology, Department of Medicine, University of Washington, Seattle, WA; Division of Clinical Research Fred Hutchinson Cancer Center, Seattle, WA
| | - Jonathan L Wright
- Department of Urology, University of Washington, Seattle, WA; Division of Clinical Research Fred Hutchinson Cancer Center, Seattle, WA
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3
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Ullah A, Lee KT, Chaudhury H, Yasinzai AQK, Chandasir A, Chaudhury T, Jamil N, Tareen B, Wali A, Sharma M, Arif D, Waheed A, Brandi L, Khan M, Iqbal A, Karki NR. Prognostic Nomogram, Demographics and Comparative Analysis of Urinary Bladder Small Cell and Large Cell Neuroendocrine Carcinoma. Clin Genitourin Cancer 2024; 22:102183. [PMID: 39236507 DOI: 10.1016/j.clgc.2024.102183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 07/25/2024] [Accepted: 07/28/2024] [Indexed: 09/07/2024]
Abstract
BACKGROUND This retrospective study aims to provide a comprehensive analysis of the demographics, survival rates, and therapeutic approaches of small-cell neuroendocrine carcinoma (SCNEC) and large-cell neuroendocrine carcinoma (LCNEC) while highlighting key differences compared to common urinary bladder cancers. METHODS Our analysis utilized the Surveillance, Epidemiology, and End Results database (SEER), and data was collected from 2000-2020. RESULTS A total of 1040 cases of urinary bladder SCNEC and LCNEC were identified. Most patients were over the age of 80 years (33.2%), male (78.9%), and Caucasian (83.6%). Most tumors were over 4.1cm (47.4%) and in the lateral wall of the bladder (37.8%). The overall 5-year survival was 22.1% (95% confidence interval (95% CI):20.7-23.5). The 5-year survival by sex was greatest for the female population (28.0%; (95% CI: 24.5-35.0). For treatment modality, the 5-year survival for each was as follows: surgery, 12.5% (95% CI: 10.5-14.5) multimodality therapy (surgery and chemotherapy), 31.1% (95% CI: 28.5-33.7) and combination (surgery, chemotherapy, and radiation) 32.8% (95% CI: 29.1-36.5). On multivariable analysis, positive nodal status hazar ratio (HR)(HR3.65 [95% CI: 2.34-5.71], P < .001) was identified as a negative predictor for survival, and increasing age was nearly significant for a worse prognosis (P = .052). The prognostic nomogram that was created to predict patient survivability mirrored the findings from the statistical analysis, with a statistically significant difference found in race, treatment modality, and tumor stage. CONCLUSIONS SCNEC and LCNEC are rare yet highly intrusive subtypes of bladder cancer that usually affect Caucasian males over the age of 80 years old. The study identifies older age and positive nodal status as adverse prognostic indicators. Our findings offer crucial insights that can inform future clinical guidelines and serve as a basis for more tailored treatment strategies for these aggressive subtypes of bladder cancer.
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MESH Headings
- Humans
- Male
- Female
- Aged
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Neuroendocrine/therapy
- Carcinoma, Neuroendocrine/mortality
- Carcinoma, Neuroendocrine/epidemiology
- Urinary Bladder Neoplasms/therapy
- Urinary Bladder Neoplasms/mortality
- Urinary Bladder Neoplasms/pathology
- Retrospective Studies
- Nomograms
- Aged, 80 and over
- SEER Program
- Prognosis
- Middle Aged
- Survival Rate
- Carcinoma, Large Cell/pathology
- Carcinoma, Large Cell/therapy
- Carcinoma, Large Cell/mortality
- Carcinoma, Large Cell/epidemiology
- Carcinoma, Small Cell/therapy
- Carcinoma, Small Cell/pathology
- Carcinoma, Small Cell/mortality
- Carcinoma, Small Cell/epidemiology
- Adult
- United States/epidemiology
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Affiliation(s)
- Asad Ullah
- Texas Tech University Health Sciences Center, Lubbock, TX.
| | | | | | | | | | | | - Nimra Jamil
- Bolan Medical College, Quetta, Balochistan, Pakistan
| | - Bisma Tareen
- Bolan Medical College, Quetta, Balochistan, Pakistan
| | - Agha Wali
- Bolan Medical College, Quetta, Balochistan, Pakistan
| | - Meenu Sharma
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - Dauod Arif
- Texas Tech University Health Sciences Center, Lubbock, TX
| | | | - Luis Brandi
- Texas Tech University Health Sciences Center, Lubbock, TX
| | | | - Asif Iqbal
- Northeastern Health System, Tahlequah, OK
| | - Nabin R Karki
- Mitchell Cancer Center, University of South Alabama, Mobile, AL
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4
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Zhou Y, Yang L. Large-cell neuroendocrine carcinoma of the bladder: A case report. World J Clin Oncol 2024; 15:1239-1244. [PMID: 39351458 PMCID: PMC11438854 DOI: 10.5306/wjco.v15.i9.1239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/26/2024] [Accepted: 06/12/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Bladder neuroendocrine tumors are few and exhibit a high degree of aggressiveness. The bladder is characterized by four distinct forms of neuroendocrine tumors. Among them, large-cell neuroendocrine carcinoma is the least prevalent, but has the highest level of aggressiveness. The 5-year survival rate for large-cell neuroendocrine carcinoma of the bladder is exceedingly poor. To date, only a few dozen cases have been reported. CASE SUMMARY Here, we report the case of a 65-year-old man with large-cell neuroendocrine carcinoma of the bladder. The patient presented to the Department of Urology at our hospital due to the presence of painless hematuria without any identifiable etiology. During hospitalization, abdominal computed tomography revealed the presence of an irregular mass on the right anterior wall of the bladder. A cystoscopic non-radical resection of the bladder lesion was performed. The postoperative pathological examination revealed large-cell neuroendocrine bladder cancer. Previous reports on cases of large-cell neuroendocrine carcinoma cases were retrieved from PubMed, and the present paper discusses the currently recognized best diagnostic and treatment options for large-cell neuroendocrine carcinoma based on the latest research progress. CONCLUSION Large-cell neuroendocrine carcinoma of the bladder is an uncommon malignancy with a highly unfavorable prognosis. Despite ongoing efforts to prolong patient survival through multidisciplinary therapy, the prognosis remains unfavorable. Large-cell neuroendocrine carcinoma continues to be a subject of uncertainty.
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Affiliation(s)
- Yu Zhou
- Department of Urology, Bishan Hospital Affiliated to Chongqing Medical University, Chongqing 402760, China
| | - Lin Yang
- Department of Urology, Bishan Hospital Affiliated to Chongqing Medical University, Chongqing 402760, China
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5
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Cui J, Zhao Q, Yu C, Ma P, Li S. Recurrent bladder urothelial carcinoma complicated with primary bladder large cell neuroendocrine carcinoma: a case report and literature review. Front Oncol 2024; 14:1369649. [PMID: 39156709 PMCID: PMC11327133 DOI: 10.3389/fonc.2024.1369649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 07/22/2024] [Indexed: 08/20/2024] Open
Abstract
Objective To improve the understanding, diagnosis and treatment of bladder large cell neuroendocrine carcinoma (LCNEC). Methods A clinical case of bladder LCNEC admitted to our hospital was reported. The epidemiology, prognosis, diagnosis and treatment methods of large cell neuroendocrine carcinoma were reviewed. The diagnosis and treatment status and prognosis were discussed based on the literature. Results The female patient was admitted to hospital for "more than 4 years after TURBT and intermittent hematuria for more than 2 years". She was diagnosed as recurrent bladder cancer and underwent "radical cystotomy + hysterectomy". The postoperative pathological findings were high-grade urothelial carcinoma of the bladder neck and large cell neuroendocrine carcinoma of the bladder. The patient recovered well after surgery, but refused radiotherapy and chemotherapy and is still under close follow-up. Conclusion Bladder LCNEC is clinically rare, has unique pathological features, is more aggressive than traditional urothelial carcinoma, and has a poor prognosis. Surgery, chemotherapy and radiotherapy should be combined with multi-mode treatment.
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Affiliation(s)
- Jiarui Cui
- North China University of Science and Technology, Tangshan, Hebei, China
- Department of Urology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Qing Zhao
- Department of Urology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Chunhong Yu
- Department of Health Examination Center, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Pengfei Ma
- North China University of Science and Technology, Tangshan, Hebei, China
- Department of Urology, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Shoubin Li
- Department of Urology, Hebei General Hospital, Shijiazhuang, Hebei, China
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6
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Bai LL, Guo YX, Song SY, Li R, Jiang YQ. Primary large cell neuroendocrine carcinoma of the bladder: A case report. World J Clin Cases 2024; 12:4783-4788. [PMID: 39070845 PMCID: PMC11235470 DOI: 10.12998/wjcc.v12.i21.4783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/15/2024] [Accepted: 06/04/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Large cell neuroendocrine carcinoma (LCNEC) of the bladder is a rare non-urothelial tumor of the bladder. The treatment of LCNEC of the bladder is different from that of urothelial carcinoma (UC); therefore, early and accurate diagnosis is particularly important. As LCNEC of the bladder is rare and its clinical symptoms and radiographic features are similar to those of urothelial tumors, the clinical diagnosis of the disease remains challenging. CASE SUMMARY We report a 72-year-old female patient who presented with gross hematuria for 3 mo. A solitary tumor located in the anterior wall of the bladder was found by cystoscopy. Pathological examination after biopsy suggested UC of the bladder in the absence of immunohistochemical assessment. The patient underwent partial cystectomy and was finally diagnosed with LCNEC (pT2bN0M0) based on the results of postoperative immunohistochemical examination. During the 10-mo follow-up, no signs of tumor recurrence or metastasis were found. CONCLUSION Immunohistochemical examination is essential for diagnosing LCNEC of the bladder. Accurate diagnosis and multidisciplinary treatment in the early stage of the disease are crucial for improving the prognosis.
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Affiliation(s)
- Liang-Liang Bai
- Department of Urology, Hebei Medical University Third Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Yue-Xian Guo
- Department of Urology, Hebei Medical University Third Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Shi-Yu Song
- Department of Urology, Hebei Medical University Third Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Ran Li
- Department of Urology, Hebei Medical University Third Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Yu-Qing Jiang
- Department of Urology, Hebei Medical University Third Hospital, Shijiazhuang 050051, Hebei Province, China
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7
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Sun Z, Liang X, Zhang C, Song S, Gao J. Primary pure large cell neuroendocrine carcinoma of the urinary bladder: a case report and literature review. Front Oncol 2024; 14:1337997. [PMID: 38529382 PMCID: PMC10961446 DOI: 10.3389/fonc.2024.1337997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/16/2024] [Indexed: 03/27/2024] Open
Abstract
Background The large cell neuroendocrine carcinoma (LCNEC) of the urinary bladder is a rare malignancy. With its high aggressiveness and poor prognosis, the disease is often accompanied by metastasis or recurrence. The lack of specific clinical manifestations and imaging features causes considerable challenges for clinical diagnosis and treatment. Case presentation We report a case of LCNEC of the urinary bladder. The patient was a 79-year-old male admitted to our hospital with recurrent episodes of asymptomatic gross hematuria. Based on the computed tomography (CT) scan findings, our patient presented with a bladder mass displaying invasion into the serosal layer, suggestive of muscle involvement and indicative of malignancy. The patient received a radical cystectomy, and the postoperative pathology confirmed primary, pure LCNEC of the urinary bladder. We gave him 16 cycles of toripalimab immunotherapy. As of follow-up, the patient was alive, and periodic CT reexamination showed no evidence of recurrence. Conclusions We reviewed domestic and foreign literature and found no explicit treatment protocols exist for the disease. Surgical resection combined with chemotherapy were the most common treatments. Herein, we reported the first case of primary, pure LCNEC of the urinary bladder treated by radical cystectomy combined with pure immunotherapy, achieving sustained remission, which provides a new idea for the immunotherapy and integrative treatment of the disease.
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Affiliation(s)
- Zhenpeng Sun
- Department of Urology, Qingdao Municipal Hospital, Qingdao, China
| | - Xin Liang
- Department of Urology, Qingdao Municipal Hospital, Qingdao, China
| | - Changcun Zhang
- Department of Urology, Qingdao Municipal Hospital, Qingdao, China
| | - Shizhang Song
- Department of Urology, Yantai Yuhuangding Hospital Qingdao University, Yantai, China
| | - Jiangang Gao
- Department of Urology, Qingdao Municipal Hospital, Qingdao, China
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8
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Mahmoudnejad N, Mohammadi Torbati P, Lashay A, Ahmadi N, Guitynavard F. Achieving a one-year-tumor-free survival in a female with primary large cell neuroendocrine carcinoma of the urinary bladder and liver metastasis; a case report. Urol Case Rep 2023; 47:102347. [PMID: 36816609 PMCID: PMC9931890 DOI: 10.1016/j.eucr.2023.102347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/29/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Primary neuroendocrine tumor (NET) of bladder is rare. It has four subtypes, and large cell neuroendocrine carcinoma (LCNEC) is the rarest. LCNEC affects mostly men over 60. Most common symptom is gross hematuria. It has no specific treatment. Metastasis is common and once occurred, average survival would be less than three months. Herein we present diagnostic and therapeutic management of a 65-year-old female with LCNEC of bladder and concurrent high-grade urothelial carcinoma. Despite developing early liver metastasis, she achieved a one-year tumor-free survival.
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Affiliation(s)
- Nastaran Mahmoudnejad
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Peyman Mohammadi Torbati
- Department of Pathology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Lashay
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Navid Ahmadi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Guitynavard
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author. Urology and Nephrology Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran.
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9
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Li S, Liu X, Weipeng L, Fu B. Nomogram to predict overall survival in patients with primary bladder neuroendocrine carcinoma: a population-based study. Future Oncol 2022; 18:4171-4181. [PMID: 36651444 DOI: 10.2217/fon-2022-0843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Aim: To develop a prognostic model to predict the overall survival of primary bladder neuroendocrine carcinoma (BNEC) patients. Methods: Using univariate and multivariate Cox regression analyses, a nomogram was constructed. Calibration curves, receiver operating characteristic curves and C-index were utilized to evaluate the performance. Results: The study enrolled 906 BNEC patients. The following variables were incorporated in the nomogram: age, marital status, Tumor node metastasis (TNM) stage, chemotherapy and surgery. The nomogram had a C-index of 0.702 in the training cohort and 0.724 in the validation cohort. Conclusion: Compared with the TNM staging system, the proposed nomogram exhibits superior prognostic discrimination and survival prediction.
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Affiliation(s)
- Sheng Li
- Department of Urology, Nanchang, China.,The First Affiliated Hospital of Nanchang University, No.17, Yongwai Zhengjie, Donghu District, Nanchang City, Jiangxi Province, 330000, China
| | - Xiaoqiang Liu
- Department of Urology, Nanchang, China.,The First Affiliated Hospital of Nanchang University, No.17, Yongwai Zhengjie, Donghu District, Nanchang City, Jiangxi Province, 330000, China
| | - Liu Weipeng
- Department of Urology, Nanchang, China.,The First Affiliated Hospital of Nanchang University, No.17, Yongwai Zhengjie, Donghu District, Nanchang City, Jiangxi Province, 330000, China
| | - Bin Fu
- Department of Urology, Nanchang, China.,The First Affiliated Hospital of Nanchang University, No.17, Yongwai Zhengjie, Donghu District, Nanchang City, Jiangxi Province, 330000, China
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10
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Wang G, Yuan R, Zhou C, Guo C, Villamil C, Hayes M, Eigl BJ, Black P. Urinary Large Cell Neuroendocrine Carcinoma: A Clinicopathologic Analysis of 22 Cases. Am J Surg Pathol 2021; 45:1399-1408. [PMID: 34074810 PMCID: PMC8428850 DOI: 10.1097/pas.0000000000001740] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Large cell neuroendocrine carcinoma (LCNEC) of the urinary tract is a rare disease. We present a relatively large retrospective cohort of urinary LCNEC, 20 from the urinary bladder, and 2 from the ureter, from a single institution. The patients included 16 men and 6 women with a median age of 74.5 years. Most LCNEC presented at an advanced stage with tumors invading the muscularis propria and beyond (21/22). Eight cases were pure LCNEC, while 14 cases were mixed with other histologic types, including conventional urothelial carcinoma (n=9), carcinoma in situ (n=7), small cell carcinoma (n=6), and urothelial carcinoma with glandular (n=3) features. Most LCNEC expressed neuroendocrine markers synaptophysin (22/22), chromogranin (13/16), CD56 (7/7), TTF1 (8/8), and INSM1 (2/3). They were negative for common urothelial markers including HMWCK (0/3), p40/p63 (0/6), CK20 (0/10), and had variable GATA3 staining (4/8). Ki-67 stained 25% to nearly 100% tumor cell nuclei. Patient survival was associated with cancer stage, and pure LCNEC showed worse survival than mixed LCNEC. Compared with small cell carcinoma at similar stages from a prior study, LCNEC had a worse prognosis only when patients developed metastatic disease. For organ-confined LCNEC, neoadjuvant chemotherapy followed by radical resection is the treatment option to achieve long-term survival.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/analysis
- Carcinoma, Large Cell/chemistry
- Carcinoma, Large Cell/mortality
- Carcinoma, Large Cell/pathology
- Carcinoma, Large Cell/therapy
- Carcinoma, Neuroendocrine/chemistry
- Carcinoma, Neuroendocrine/mortality
- Carcinoma, Neuroendocrine/pathology
- Carcinoma, Neuroendocrine/therapy
- Chemotherapy, Adjuvant
- Cystectomy
- Databases, Factual
- Female
- Humans
- Male
- Middle Aged
- Neoadjuvant Therapy
- Neoplasm Invasiveness
- Neoplasm Staging
- Retrospective Studies
- Treatment Outcome
- Ureteral Neoplasms/chemistry
- Ureteral Neoplasms/mortality
- Ureteral Neoplasms/pathology
- Ureteral Neoplasms/therapy
- Urinary Bladder Neoplasms/chemistry
- Urinary Bladder Neoplasms/mortality
- Urinary Bladder Neoplasms/pathology
- Urinary Bladder Neoplasms/therapy
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Affiliation(s)
- Gang Wang
- Departments of Pathology
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Ren Yuan
- Radiology
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chen Zhou
- Departments of Pathology
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Charles Guo
- Department of Pathology, MD Anderson Cancer Center, Houston, TX
| | - Carlos Villamil
- Departments of Pathology
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Malcolm Hayes
- Departments of Pathology
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Bernhard J. Eigl
- Medical Oncology, British Columbia Cancer Vancouver Centre
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Peter Black
- Department of Urology, Vancouver General Hospital
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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11
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Pelosi G, Bianchi F, Dama E, Metovic J, Barella M, Sonzogni A, Albini A, Papotti M, Gong Y, Vijayvergia N. A Subset of Large Cell Neuroendocrine Carcinomas in the Gastroenteropancreatic Tract May Evolve from Pre-existing Well-Differentiated Neuroendocrine Tumors. Endocr Pathol 2021; 32:396-407. [PMID: 33433886 DOI: 10.1007/s12022-020-09659-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 02/06/2023]
Abstract
In the gastro-entero-pancreatic (GEP) tract, neuroendocrine neoplasms (NENs) include well differentiated neuroendocrine tumors (NETs) and high-grade NE carcinomas (NECs), which are thought to make up separate and mutually exclusive tumor entities. Little is known, however, as to whether there may be any pathogenetic link between them. Clustering analysis of a 10-gene panel generated from a previously reported next-generation sequencing analysis on 48 GEP-NENs with clinical annotations was used in the study. Unsupervised cluster analysis showed three histology-independent clusters, namely, C1, C2, and C3, which accounted for 44% of patients but the entire array of mutations. All but two NECs fell into the clusters, yet with different prevalence rates (p < 0.0001). A model was devised according to which NETs were likely to evolve into NECs upon progression of C3 into C1 and C2, despite different morphology. The median Ki-67 labeling index was 5% in C3 showing better prognosis and 50% in C1 and C2 experiencing worse prognosis, with an impressive intra-tumor heterogeneity of diversely proliferating tumor areas. This study suggests that a subset of large cell NECs in the gastroenteropancreatic tract may evolve from pre-existing well-differentiated NETs.
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Affiliation(s)
- Giuseppe Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
- Inter-Hospital Pathology Division, IRCCS MultiMedica, Milan, Italy.
| | - Fabrizio Bianchi
- Cancer Biomarker Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Elisa Dama
- Cancer Biomarker Unit, Fondazione IRCCS Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy
| | - Jasna Metovic
- Department of Oncology, University of Turin, Turin, Italy
| | - Marco Barella
- Inter-Hospital Pathology Division, IRCCS MultiMedica, Milan, Italy
| | - Angelica Sonzogni
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Adriana Albini
- Laboratory of Vascular Biology and Angiogenesis, IRCCS MultiMedica, Milan, Italy
| | - Mauro Papotti
- Department of Oncology, University of Turin, Turin, Italy
| | - Yulan Gong
- Department of Pathology, Fox Chase Cancer Centre, Philadelphia, PA, USA
| | - Namrata Vijayvergia
- Department of Medical Oncology, Fox Chase Cancer Centre, Philadelphia, PA, USA
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12
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Tlili G, Ammar H, Majdoub W, Dziri S, Farhat W, Acacha E, Gupta R, Jalleli N, Azzabi A, Jaidane M. Paraplegia due to medullary compression caused by a large cell neuroendocrine carcinoma of the urinary bladder: A case report. Ann Med Surg (Lond) 2021; 67:102475. [PMID: 34188905 PMCID: PMC8220165 DOI: 10.1016/j.amsu.2021.102475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/30/2021] [Accepted: 06/04/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Neuroendocrine carcinomas of the urinary bladder are rare tumors, estimated at less than 1% of urinary bladder malignancies. They are mainly represented by small cell neuroendocrine carcinoma, while large cell neuroendocrine carcinoma (LCNEC) is rarely reported. CASE PRESENTATION We report a case of a 49-year-old man presenting paraplegia caused by a metastatic urinary bladder LCNEC, which was managed with palliative external beam radiotherapy (EBRT) associated with MVAC chemotherapy, including methotrexate, vinblastine sulfate, doxorubicin hydrochloride (Adriamycin), and cisplatin. At the last follow-up of one year after his admission, there was a symptomatic improvement in the pain intensity. CONCLUSION LCNEC of the bladder was first described in 1986, and, until now, less than 40 cases have been published in the literature. To the best of our knowledge, this is the first case of primary LCNEC of the urinary bladder presenting with paraplegia.
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Affiliation(s)
- Ghassen Tlili
- Department of Urology, Sahloul Hospital, Sousse, Tunisia
| | - Houssem Ammar
- Department of Gastrointestinal Surgery, Sahloul Hospital, Sousse, Tunisia
| | - Wiem Majdoub
- Department of Anatomopathology, Sahloul Hospital, Sousse, Tunisia
| | - Sonia Dziri
- Department of Nephrology, Sahloul Hospital, Sousse, Tunisia
| | - Waad Farhat
- Department of Gastrointestinal Surgery, Sahloul Hospital, Sousse, Tunisia
| | - Emir Acacha
- Department of Urology, Sahloul Hospital, Sousse, Tunisia
| | - Rahul Gupta
- Department of Gastrointestinal Surgery, Synergy Institute of Medical Sciences, Dehradun, India
| | | | - Awatef Azzabi
- Department of Nephrology, Sahloul Hospital, Sousse, Tunisia
| | - Mehdi Jaidane
- Department of Urology, Sahloul Hospital, Sousse, Tunisia
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13
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Golijanin B, Gershman B, De Souza A, Kott O, Carneiro BA, Mega A, Golijanin DJ, Amin A. p53 Expression, Programmed Death Ligand 1, and Risk Factors in Urinary Tract Small Cell Carcinoma. Front Oncol 2021; 11:651754. [PMID: 33968753 PMCID: PMC8101844 DOI: 10.3389/fonc.2021.651754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/15/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Small cell carcinoma of the urinary tract (SCCUT) is a rare finding with poor clinical course. This study sheds light on the molecular subtype and identifies risk factors in patients diagnosed with SCCUT. Methods: Immunohistochemical expression of immunotherapy target programmed death ligand 1 (PD-L1) and luminal (GATA3), basal (p63), and p53 markers are assessed in patients diagnosed with SCCUT. Univariate analysis identified risk factors. Overall survival (OS) is computed using the Kaplan–Meier method. Results: Tissue was available for 70.2% (33/47). All showed a high PD-L1 expression phenotype. p53 is seen in 93.9% (31/33), mostly as overexpression, GATA3 in 45.5% (15/33), and p63 in 57.6% (19/33). For the entire cohort (n = 47), 1-year survival was 59.6%, and the median OS was 17 months. Univariate analysis shows that chemotherapy [hazard ratio (HR) = 0.29, 95% confidence interval (CI) = 0.14–0.61, p = 0.001], radical surgery (HR = 0.37, 95% CI = 0.18–0.76, p = 0.007), and diagnosis of non-pure SCCUT (HR = 0.44, 95% CI = 0.22–0.86, p = 0.02) are favorable prognostic features. Metastasis had negative associations with survival (HR = 2.1, 95% CI = 1.1–4.2, p = 0.03). Conclusions: In this series, pure and mixed SCCUT are characterized by p53 overexpression and a high PD-L1 phenotype. Histology of non-pure SCCUT is a positive prognosticator, and radical cystectomy or chemotherapy can improve OS. These findings demonstrate that SCCUT may be eligible for PD-L1 immunotherapy.
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Affiliation(s)
- Borivoj Golijanin
- Department of Pathology and Laboratory Medicine, The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, United States.,Urology Department, Minimally Invasive Urology Institute, The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Boris Gershman
- Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Andre De Souza
- Oncology Department, Lifespan Cancer Institute, The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Ohad Kott
- Urology Department, Minimally Invasive Urology Institute, The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Benedito A Carneiro
- Oncology Department, Lifespan Cancer Institute, The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Anthony Mega
- Oncology Department, Lifespan Cancer Institute, The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Dragan J Golijanin
- Urology Department, Minimally Invasive Urology Institute, The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Ali Amin
- Department of Pathology and Laboratory Medicine, The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, United States
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14
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Xia K, Zhong W, Chen J, Lai Y, Huang G, Liu H, Dong W, He W, Lin T, Huang J. Clinical Characteristics, Treatment Strategy, and Outcomes of Primary Large Cell Neuroendocrine Carcinoma of the Bladder: A Case Report and Systematic Review of the Literature. Front Oncol 2020; 10:1291. [PMID: 32850401 PMCID: PMC7399333 DOI: 10.3389/fonc.2020.01291] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 06/22/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose: The aim of this study was to review the clinicopathologic characteristics, treatments, and outcomes of patients with primary large cell neuroendocrine carcinoma of the bladder (LCNEC). Patients and Methods: We report one patient diagnosed with primary pure LCNEC of the bladder in Sun Yat-sen Memorial Hospital. In addition, we performed a systematic literature review, in April 2020, on case report and case series of LCNEC of the bladder. The clinicopathologic characteristics, treatments and outcomes of this rare disease were analyzed. Results: A total of 39 patients were included in our analysis (1 case from our institution and 38 cases from the literature). Most patients (79.5%) were male. The average age at the surgery for the patients is 61.5 years (range 19–85 years). The most common symptom was hematuria (n = 20, 76.9%). Almost all patients (38, 97.4%) underwent surgery, with 26 (66.7%) receiving multimodality therapy. Out of 24 patients with available data, regional or distant recurrences developed in 14 patients (58.3%). The median overall survival of the patients was 11.5 months, with 1- and 3-year survival rates of 54.0 and 21.4%, respectively. In the survival analysis, theT1–2 tumors (P = 0.025), no distant metastases at diagnosis (P = 0.001), and multimodality therapy (P = 0.017) were associated with better overall survival (OS). Conclusions: LCNEC of the bladder is an extremely rare neoplasm. The available data suggest that the disease has an aggressive natural history with poor prognosis. Early pathologic stage and multimodality treatment may be important factors in determining prognosis.
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Affiliation(s)
- Kun Xia
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wenlong Zhong
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Junyu Chen
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yiming Lai
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guohui Huang
- Department of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hao Liu
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wen Dong
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wang He
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tianxin Lin
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jian Huang
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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15
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Li W, Su ZZ, Kang JH, Xie XY, Xie XH, Zhuang BW. Application of contrast-enhanced ultrasonography for large cell neuroendocrine carcinoma in the urinary bladder: a case report. BMC Med Imaging 2020; 20:46. [PMID: 32362278 PMCID: PMC7197184 DOI: 10.1186/s12880-020-00447-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 04/23/2020] [Indexed: 11/14/2022] Open
Abstract
Background Large cell neuroendocrine carcinoma (LCNEC) of the urinary bladder is an uncommon malignant bladder tumor, and the overall prognosis is poor. Contrast-enhanced ultrasound (CEUS) provides a new effective modality for tumor detection and diagnosis. Case presentation A 30-year-old man complained of repeated painless gross haematuria for half a month. Conventional ultrasound demonstrated a hypoechoic solitary lesion with hyperechoic margins measuring 3.4 × 3.1 cm in the anterior wall of the bladder. Superb microvascular imaging (SMI) showed a strong flow signal in the mass. CEUS revealed that the lesion was characterized by hyper-enhancement in the early phase and hypo-enhancement in the late phase. The entire bladder wall was disrupted by homogeneous hyper-enhanced tumor tissue on CEUS. Time-intensity curves (TICs) showed a rapid wash-in with a high maximum signal intensity (SI) and quick wash-out. Finally, partial cystectomy was performed and the pathological examination confirmed the diagnosis of LCNEC with invasion into the whole layer of the bladder wall. Conclusion This case suggested that CEUS was a valuable imaging method to detect and diagnose LCNEC in the bladder, and that CEUS can provide information related to the depth of wall invasion and the microvasculature.
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Affiliation(s)
- Wei Li
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, 7/F, 2nd Building, 58# Zhongshan Road 2, Guangzhou, 510080, People's Republic of China
| | - Ze-Zhen Su
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, 7/F, 2nd Building, 58# Zhongshan Road 2, Guangzhou, 510080, People's Republic of China
| | - Ji-Hui Kang
- Department of Pathology, The First Affiliated Hospital of Sun Yat-Sen University, NO.58 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China
| | - Xiao-Yan Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, 7/F, 2nd Building, 58# Zhongshan Road 2, Guangzhou, 510080, People's Republic of China
| | - Xiao-Hua Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, 7/F, 2nd Building, 58# Zhongshan Road 2, Guangzhou, 510080, People's Republic of China
| | - Bo-Wen Zhuang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, 7/F, 2nd Building, 58# Zhongshan Road 2, Guangzhou, 510080, People's Republic of China.
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16
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Wang Y, Li Q, Wang J, Tong M, Xing H, Xue Y, Pan H, Huang C, Li D. Small cell carcinoma of the bladder: the characteristics of molecular alterations, treatment, and follow-up. Med Oncol 2019; 36:98. [PMID: 31664527 DOI: 10.1007/s12032-019-1321-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 10/14/2019] [Indexed: 12/12/2022]
Abstract
Small cell carcinoma of the bladder (SCCB) is a rare disease associated with high invasiveness and mortality. Histologically, SCCB is difficult to distinguish from small cell lung cancer (SCLC); however, it shares more similar molecular alterations with urothelial carcinoma (UC). As a result, now, the widely accepted theory about the cells of origin is that SCCB and UC probably have a common clone origin. Even the former probably comes from a preexisting UC. At present, given its rarity, early diagnoses, treatments, and follow-ups are not well established, which are vital to patients with SCCB. Inspirationally, in recent years, with the development of molecular diagnostic methods, molecular alterations of SCCB have been understood partially, which are propitious to excavate new potential therapeutic strategies and establish sound follow-ups. Therefore, the future will be light for patients with SCCB.
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Affiliation(s)
- Yanling Wang
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China
| | - Qijun Li
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China
| | - Jing Wang
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China
| | - Mengting Tong
- Second Department of Medical Oncology, The Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, Xinjiang, China
| | - Haibo Xing
- Deparment of ICU, Xiasha Campus, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310019, Zhejiang, China
| | - Yanan Xue
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China
| | - Hongming Pan
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China
| | - Changxing Huang
- Department of Medical Oncology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310020, Zhejiang, China
| | - Da Li
- Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, Zhejiang, China.
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17
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Erdem GU, Dogan M, Aytekin A, Sahin S, Cinkir HY, Sakin A, Ozcelik M, Bozkurt O, Sezer E, Demirci NS, Bozkaya Y, Zengin N. Clinical outcomes of patients with pure small cell carcinoma of the urinary bladder. Ir J Med Sci 2019; 189:431-438. [PMID: 31463895 DOI: 10.1007/s11845-019-02074-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 07/24/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES There is not yet a standardized approach to treat patients with small cell carcinoma of the bladder (SmCCB). This study aims to investigate the clinical features, treatment, and survival outcomes of patients with pure SmCCB. MATERIALS AND METHODS Patients diagnosed with SmCCB between January 2006 and September 2015 were retrospectively evaluated. RESULTS A total of 34 patients with a median age of 63.0 years were included in the study, with a male to female ratio of 4.6:1.0. At the time of diagnosis, 22 patients (64.7%) had stage IV disease. At a median follow-up time of 12.7 months, 67.6% of patients died of bladder carcinoma, with an overall survival (OS) of 15.7 months for all patients. In the patients with stages I-III, nodal involvement, and distant metastases, the median OS was 31.8, 15.7, and 8.4 months, respectively (P = 0.005). Considering the survival rates of the patients (stages I-III) treated with surgery vs. local therapy, there was not a statistically significant difference (26.6 months and 31.8 months, P = 0.97, respectively). A multivariate analysis revealed that stage IV disease and poor ECOG performance status were associated with OS. CONCLUSION The optimal treatment of SmCCB has been under debate. For the patients with advanced stage of disease (T4b, N+, M+), platinum containing chemotherapeutic agents should be preferred. Stage IV disease and poor ECOG performance status were associated with shorter OS.
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Affiliation(s)
- Gokmen Umut Erdem
- Department of Medical Oncology, Kocaeli Derince Training and Research Hospital, 41310, Kocaeli, Turkey.
| | - Mutlu Dogan
- Department of Medical Oncology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Aydin Aytekin
- Department of Medical Oncology, Medical Faculty of Gazi University, Ankara, Turkey
| | - Suleyman Sahin
- Department of Medical Oncology, Van Training and Research Hospital, Van, Turkey
| | - Havva Yeşil Cinkir
- Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Abdullah Sakin
- Department of Medical Oncology, Okmeydani Training and Research Hospital, İstanbul, Turkey
| | - Melike Ozcelik
- Department of Medical Oncology, Kartal Training and Research Hospital, İstanbul, Turkey
| | - Oktay Bozkurt
- Department of Medical Oncology, Medical Faculty of Erciyes University, Kayseri, Turkey
| | - Emel Sezer
- Department of Medical Oncology, Medical Faculty of Mersin University, Mersin, Turkey
| | | | - Yakup Bozkaya
- Department of Medical Oncology, Edirne State Hospital, Edirne, Turkey
| | - Nurullah Zengin
- Department of Medical Oncology, Ankara Numune Training and Research Hospital, Ankara, Turkey
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18
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Niu Q, Lu Y, Xu S, Shi Q, Guo B, Guo Z, Huang T, Wu Y, Yu J. Clinicopathological characteristics and survival outcomes of bladder neuroendocrine carcinomas: a population-based study. Cancer Manag Res 2018; 10:4479-4489. [PMID: 30349380 PMCID: PMC6190820 DOI: 10.2147/cmar.s175286] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Bladder neuroendocrine carcinomas (BNECs) are relatively a rare type of tumor. The aim of this study was to examine the clinicopathological characteristics and predictors of survival outcomes of patients with BNECs based on the analysis of the national Surveillance, Epidemiology, and End Results (SEER) database. Materials and methods Kaplan-Meier analysis with log-rank test was used for survival comparisons. Multivariate Cox regression model was employed to analyze the effect of different treatments on overall survival (OS) and cancer-specific survival (CSS). Results A total of 910 patients were identified between 2004 and 2014. Overall, 648 (71.2%) patients had small cell neuroendocrine carcinoma (SCNEC), 35 (3.8%) had large cell neuroendocrine carcinoma (LCNEC), 10 (1.1%) had carcinoid tumor (well-differentiated neuroendocrine tumor), 16 (1.8%) had paraganglioma/pheochromocytoma (PGL/PHEO), 619 (68.0%) had a poorly differentiated or undifferentiated histology grade, 214 (23.5%) presented with metastatic disease, 586 (64.4%) underwent transurethral ablation/destruction for bladder tumor, and 245 (26.9%) had partial/total cystectomy. Cystectomy+chemotherapy+radiotherapy (CCR) has the highest long-term survival rate among various treatments. The 1-, 3-, and 5-years CSS of CCR were 56%, 56%, and 56%, respectively. By using multivariable Cox proportional hazard model, age, histology, N stage, SEER stage, tumor size, radiotherapy, chemotherapy, and local treatment of the primary site were identified as independent predictors for OS and CSS; all P<0.05. Conclusion In BNEC, SCNEC has an absolute advantage in number. SCNEC/LCNEC tend to be older men. PGL/PHEO and carcinoid tumors have younger mean ages, earlier tumor stages, and better prognosis than SCNEC/LCNEC. Surgery, radiotherapy and chemotherapy are better than conservative treatment. However, whatever cystectomy or bladder sparing, chemotherapy should be a major component of treatment.
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Affiliation(s)
- Quan Niu
- Department of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Youyi Lu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, People's Republic of China
| | - Shigao Xu
- Department of Urology, Subei People's Hospital of Jiangsu Province (Clinical Medical College, Yangzhou University), Yangzhou, Jiangsu, People's Republic of China,
| | - Qun Shi
- Department of Urology, Subei People's Hospital of Jiangsu Province (Clinical Medical College, Yangzhou University), Yangzhou, Jiangsu, People's Republic of China,
| | - Baoyu Guo
- Department of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Zhe Guo
- Department of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Tianbao Huang
- Department of Urology, Subei People's Hospital of Jiangsu Province (Clinical Medical College, Yangzhou University), Yangzhou, Jiangsu, People's Republic of China,
| | - Yinxia Wu
- Department of Oncology, Subei People's Hospital of Jiangsu Province (Clinical Medical College, Yangzhou University), Yangzhou, Jiangsu, People's Republic of China,
| | - Junjie Yu
- Department of Urology, Subei People's Hospital of Jiangsu Province (Clinical Medical College, Yangzhou University), Yangzhou, Jiangsu, People's Republic of China,
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19
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Akdeniz E, Bakirtas M, Bolat MS, Akdeniz S, Özer I. Pure large cell neuroendocrine carcinoma of the bladder without urological symptoms. Pan Afr Med J 2018; 30:134. [PMID: 30374380 PMCID: PMC6201621 DOI: 10.11604/pamj.2018.30.134.13437] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 05/21/2018] [Indexed: 11/25/2022] Open
Abstract
Neuroendocrine carcinoma is one of the uncommonly seen pathologies of the urinary bladder. Macroscopic hematuria is frequently encountered symptom in patients with neuroendocrine carcinoma. We report a 45-year-old man with left solitary kidney and oliguria for five days the development of acute renal failure (ARF) with the impaired general condition. The underlying cause being identified as pure type large-cell neuroendocrine carcinoma of the bladder. Large-cell neuroendocrine carcinoma of the bladder is an uncommon fatal tumor. No macroscopic hematuria or urological symptom was observed in our case. Advanced ectasia was not observed in the kidney, and the patient's clinical status was complicated with ARF. It must not be forgotten that in some bladder tumors, the patient's general condition may be impaired without urological symptoms.
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Affiliation(s)
- Ekrem Akdeniz
- Health Sciences University, Samsun Training and Research Hospital, Department of Urology, Samsun, Turkey
| | - Mustafa Bakirtas
- Health Sciences University, Samsun Training and Research Hospital, Department of Pathology, Samsun, Turkey
| | - Mustafa Suat Bolat
- Health Sciences University, Samsun Training and Research Hospital, Department of Urology, Samsun, Turkey
| | - Sevda Akdeniz
- Health Sciences University, Samsun Training and Research Hospital, Department of Anesthesiology and Reanimation, Samsun, Turkey
| | - Ismail Özer
- Health Sciences University, Samsun Training and Research Hospital, Department of Nephrology, Samsun, Turkey
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20
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External Beam Radiation and Brachytherapy for Prostate Cancer: Is It a Possible Trigger of Large Cell Neuroendocrine Carcinoma of the Urinary Bladder? Case Rep Oncol Med 2017. [PMID: 28638669 PMCID: PMC5468577 DOI: 10.1155/2017/1853985] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Neuroendocrine tumors commonly involve the respiratory and gastrointestinal systems. Primary genitourinary neuroendocrine tumors are rare, accounting for less than 1% of all bladder carcinomas. Four histopathologic subtypes have been described. Among those, large cell neuroendocrine carcinoma (LCNEC) is the least common, is more aggressive, and generally presents in an advanced stage with poor prognosis compared to transitional cell bladder carcinoma. There is no standardized treatment regimen because of the rarity of the disease. Herein, we present a case of 72-year-old male patient with previously treated prostate cancer, who received external beam radiation therapy and high dose brachytherapy, presenting with intermittent hematuria. Cystoscopy and transurethral resection of bladder tumor (TURBT) were performed. The histopathology and immunohistochemistry were consistent with large cell neuroendocrine carcinoma (LCNEC). Further studies are required to proof the higher risk of neuroendocrine carcinoma of the bladder in patients treated with external beam radiation therapy and brachytherapy for prostate cancer.
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Chong V, Zwi J, Hanning F, Lim R, Williams A, Cadwallader J. A case of large cell neuroendocrine carcinoma of the bladder with prolonged spontaneous remission. J Surg Case Rep 2017; 2017:rjw179. [PMID: 28560016 PMCID: PMC5441246 DOI: 10.1093/jscr/rjw179] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 05/04/2017] [Indexed: 11/13/2022] Open
Abstract
Large cell neuroendocrine carcinoma (LCNEC) of the urinary bladder are rare. We present a case of a 72-year-old man who presented with back pain and acute renal failure. Ultrasound showed a soft tissue mass in the base of the bladder causing bilateral ureteric obstruction. Subsequent biopsy of this mass demonstrated neuroendocrine carcinoma. He was commenced on neoadjuvant chemotherapy (carboplatin/etoposide) and proceeded to a radical cysto-prostatectomy. Histology revealed a LCNEC involving the bladder, T4a with invasion through to adipose tissue and posteriorly at perivesical resection margins. In addition, there was a Gleason score 9 prostatic adenocarcinoma, distinct from the neuroendocrine carcinoma. Following surgery, the patient developed gross local-regional recurrence and refused further systemic therapy. However, 1 year following referral to palliative care, a further CT-PET showed complete spontaneous remission of his disease. There are only few case reports of LCNEC of the urinary bladder therefore the pathogenesis and treatment protocol are still unclear. This case report highlights the unpredictable nature of this disease.
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Affiliation(s)
- Vincent Chong
- Department of Urology, Auckland City Hospital, Auckland, New Zealand
| | - Jonathan Zwi
- Department of Pathology, Auckland City Hospital, Auckland, New Zealand
| | - Fritha Hanning
- Department of Oncology, Auckland City Hospital, Auckland, New Zealand
| | - Remy Lim
- Department of Radiology, Auckland City Hospital, Auckland, New Zealand
| | - Andrew Williams
- Department of Urology, Auckland City Hospital, Auckland, New Zealand
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Erdem GU, Özdemir NY, Demirci NS, Şahin S, Bozkaya Y, Zengin N. Small cell carcinoma of the urinary bladder: changing trends in the current literature. Curr Med Res Opin 2016; 32:1013-21. [PMID: 26889739 DOI: 10.1185/03007995.2016.1155982] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Extrapulmonary small cell carcinoma (SmCC), also known as oat cell carcinoma or small cell neuroendocrine carcinoma, is characterized by an aggressive clinical course with early metastasis pattern and a short life expectancy. So far, there is no prospective, data-based case-control study due to its low incidence. The purpose of this paper is to discuss the epidemiology, morphopathology, clinical characteristics, differential diagnosis and treatment of bladder SmCC in the light of the literature. Scope PubMed and American Society of Clinical Oncology Meeting abstracts were searched according to the following keywords: 'extrapulmonary SmCC', 'bladder cancer', and 'therapeutic approach'. The last search was performed on 1 October 2015. Some additional papers were determined by reviewing references of the appropriate articles. Most of the data regarding small cell carcinoma of the urinary bladder (SmCCB) were found to be based on the retrospective trials. Findings Bladder SmCC is more frequent in men and usually appears in the seventh to eighth decades. Macroscopic hematuria is the most common clinical symptom. The diagnosis of SmCCB is performed based on the same criteria determined by the WHO classification for the diagnosis of small cell lung carcinoma (SCLC). Prognosis is closely correlated with the stage at presentation. Although the prognosis of the disease is poor, a long survival can be achieved particularly by radical surgery following neoadjuvant chemotherapy in patients with early stage tumors. Cystectomy is still the current standard local treatment. However, cystectomy alone is not sufficient. Chemotherapy and definitive radiotherapy should be preferred for limited disease in patients who are not candidate for surgery. Conclusion Considering the poor prognosis of the disease, further studies are needed to determine the optimal treatment options and new molecular markers in the way of early diagnosis and favorable outcomes. Prospective, multicenter, randomized studies are required to evaluate the role of neoadjuvant chemotherapy followed either by surgery or radiotherapy.
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Affiliation(s)
- Gökmen Umut Erdem
- a Ankara Numune Education and Research Hospital , Department of Medical Oncology , Ankara , Turkey
| | - Nuriye Yıldırım Özdemir
- a Ankara Numune Education and Research Hospital , Department of Medical Oncology , Ankara , Turkey
| | - Nebi Serkan Demirci
- a Ankara Numune Education and Research Hospital , Department of Medical Oncology , Ankara , Turkey
| | - Süleyman Şahin
- b Dışkapı Education and Research Hospital , Department of Medical Oncology , Ankara , Turkey
| | - Yakup Bozkaya
- a Ankara Numune Education and Research Hospital , Department of Medical Oncology , Ankara , Turkey
| | - Nurullah Zengin
- a Ankara Numune Education and Research Hospital , Department of Medical Oncology , Ankara , Turkey
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Nakamaru K, Ikeura T, Miyoshi H, Takaoka M, Danbara N, Horitani S, Masuda M, Yamada Y, Uemura Y, Toyokawa H, Satoi S, Kwon AH, Okazaki K. Successful Multidisciplinary Therapy for Small Cell Carcinomas Arising from the Extrahepatic Bile Duct. Intern Med 2015; 54:2711-5. [PMID: 26521898 DOI: 10.2169/internalmedicine.54.4603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 74-year-old man was diagnosed with small cell carcinoma arising from the extrahepatic bile duct according to a histological examination of the biopsy specimen obtained during endoscopic retrograde cholangiopancreatography. Additionally, bulky hilar lymphadenopathy was observed, and the patient was treated with the combination of radiation and chemotherapy (cisplatin and irinotecan). Post-therapy, he underwent pancreaticoduodenectomy. The histological examination of the resected specimen revealed no residual cancer cells in the bile duct wall and a small amount of cancer cells in only a single lymph node. Due to this multidisciplinary therapy, the patient showed no signs of recurrence 12 months postoperatively.
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Affiliation(s)
- Koh Nakamaru
- The Third Department of Internal Medicine, Kansai Medical University, Japan
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