Clinical Management of Small-Cell Carcinoma of the Urinary Tract: A 10-Year Single-Center's Experience

There is controversy about the ideal clinical management of small-cell cancer of the urinary tract (SCCUT). The neuron-specific enolase (NSE) serum levels have never been studied in patients with SCCUT. Twelve patients diagnosed and treated in our institution during the past 10 years were evaluated. The clinical outcome and NSE levels at diagnosis and during treatment were assessed. Patients with limited disease and/or those with tumors of bladder origin showed a longer progression-free survival and overall survival. NSE levels decreased during chemotherapy administration in all patients with ED and baseline high levels. Background: Small-cell carcinoma (SCC) comprises 1% of primary bladder tumors and approximately 2% of prostate neoplasms. Metastatic disease at diagnosis is common, and survival outcomes are extremely poor. There is controversy about the ideal clinical management of these patients. The neuron-specific enolase (NSE) serum levels have never been studied in patients with small-cell carcinoma of the urinary tract (SCCUT). Patients and Methods: We report the clinical outcome of 12 consecutive SCCUT patients treated during the past 10 years. We also study the NSE levels at diagnosis and during treatment. Results: Patients with limited disease (LD) experienced a nonsignificant longer progression-free survival (PFS) and overall survival (OS) compared with extensive disease (ED) subjects. Patients with bladder SCC showed a significantly higher median PFS compared with prostate SCCUT patients (22 vs. 6 months; P = .034), although that difference did not impact on a significant longer OS. NSE levels decreased during chemotherapy administration in all patients with ED and baseline high levels. Conclusions: Our patients showed a poor prognosis as described in previous studies. A better outcome for patients with bladder SCC compared with prostate SCC could be suggested. Serum NSE levels should be further evaluated to prove its potential use in early diagnosis and treatment monitoring during chemotherapy. (C) 2013 Elsevier Inc. All rights reserved.