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- Title
Low Incidence of Brain Metastases From Small Cell Carcinoma of the Urinary Bladder.
- Authors
Bex, Axel; Sonke, Gabe S.
- Abstract
Small cell carcinoma of the urinary bladder (SCBC) is one of the most common sites of extrapulmonary small cell carcinoma, although it accounts for only 1% of all bladder tumors. Analogous to small cell lung cancer (SCLC), a clinically relevant two-stage system of limited disease (LD) and extensive disease (ED) is adopted to determine prognosis and treatment. About one-third of the patients with SCBC present with LD. Similar to the treatment of SCLC, platinum-based systemic chemotherapy forms the cornerstone of treatment and has been associated with significantly improved survival. Local therapy may consist of transurethral resection (TUR), partial cystectomy, or radiotherapy. In patients with ED, palliative platinum-based chemotherapy is the only treatment known to affect survival. In SCLC, the incidence of brain metastases is high but can be reduced by 26_50% through the administration of prophylactic cranial irradiation (PCI), leading to improved disease-free and overall survival. We conducted a literature search and review to analyze the incidence and management of brain metastasis in SCBC. The combined analysis reveals a cumulative incidence of 11% (95% confidence interval 8-14%), approximately sixfold lower than reported in SCLC. Due to the absence of structured follow-up of patients, the true incidence of brain metastases in SCBC may be underestimated. We discuss the potential reasons and suggest recommendations for follow-up and treatment of brain metastases from SCBC.
- Subjects
BLADDER cancer treatment; BRAIN metastasis; CANCER treatment; SMALL cell lung cancer; SMALL cell carcinoma; CANCER chemotherapy; TRANSURETHRAL prostatectomy; THERAPEUTICS
- Publication
European Journal of Clinical & Medical Oncology, 2012, Vol 4, Issue 1, p59
- ISSN
1759-8958
- Publication type
Article