Cheng Liang, Pan Chong-Xian, Yang Ximing J, Lopez-Beltran Antonio, MacLennan Gregory T, Lin Haiqun, Kuzel Timothy M, Papavero Veronica, Tretiakova Maria, Nigro Kelly, Koch Michael O, Eble John N
Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis 46202, USA.
Cancer. 2004 Sep 1;101(5):957-62. doi: 10.1002/cncr.20456.
Small cell carcinoma of the urinary bladder is an uncommon tumor that has been described in case reports or small series. Herein, the authors report a series of 64 patients with small cell carcinoma of the urinary bladder.
Histologic slides and medical records from 64 patients with small cell carcinoma of the urinary bladder were reviewed for morphologic, demographic, and clinical data. All patients fulfilled the criteria established for small cell carcinoma according to the World Health Organization classification system. The 2002 tumor, lymph node, and metastasis (TNM) system was used for pathologic staging. The correlations of various clinicopathologic characteristics with survival were analyzed.
Patients ranged in age from 36 years to 85 years (mean age, 66 years). The male-to-female ratio was 3.3:1.0. Among patients with clinical information available, 65% had a history of cigarette smoking, and 88% presented with hematuria. All but one patient had muscle-invasive disease at presentation. Thirty-eight patients (59%) underwent cystectomy. Sixty-six percent of patients had lymph node metastasis at the time of cystectomy. Twenty patients (32%) had pure small cell carcinoma, and 44 patients (68%) had small cell carcinoma with other histologic types (35 patients had urothelial carcinoma, 4 patients had adenocarcinoma, 2 patients had sarcomatoid urothelial carcinoma, and 3 patients had both adenocarcinoma and urothelial carcinoma). With a mean follow-up of 21 months, 68% of patients died of bladder carcinoma. None of the clinicopathologic parameters studied (age, gender, presenting symptoms, smoking history, the presence of a nonsmall cell carcinoma component, chemotherapy, or radiation therapy) were associated with survival. No significant survival difference was found between patients who did and did not undergo cystectomy (P = 0.65). Patients who had organ-confined disease had marginally better survival compared with patients who had nonorgan-confined disease (P = 0.06). The overall, 1-year, 18-month, 3-year, and 5-year disease-specific survival rates were 56%, 41%, 23%, and 16%, respectively.
The prognosis for patients with small cell carcinoma of the urinary bladder remains poor, even though the overall survival for patients with bladder carcinoma has improved significantly over the last decade.
膀胱小细胞癌是一种罕见肿瘤，此前仅有病例报告或小样本系列研究。在此，作者报告了一组64例膀胱小细胞癌患者。
回顾64例膀胱小细胞癌患者的组织学切片和病历，以获取形态学、人口统计学和临床数据。所有患者均符合世界卫生组织分类系统中关于小细胞癌的诊断标准。采用2002年肿瘤、淋巴结和转移（TNM）系统进行病理分期。分析各种临床病理特征与生存率的相关性。
患者年龄范围为36岁至85岁（平均年龄66岁）。男女比例为3.3∶1.0。在有临床资料的患者中，65%有吸烟史，88%出现血尿。除1例患者外，所有患者初诊时均为肌层浸润性病变。38例患者（59%）接受了膀胱切除术。66%的患者在膀胱切除时已有淋巴结转移。20例患者（32%）为单纯小细胞癌，44例患者（68%）为小细胞癌合并其他组织学类型（35例为尿路上皮癌，4例为腺癌，2例为肉瘤样尿路上皮癌，3例同时有腺癌和尿路上皮癌）。平均随访21个月，68%的患者死于膀胱癌。所研究的临床病理参数（年龄、性别、症状、吸烟史、非小细胞癌成分、化疗或放疗）均与生存率无关。接受和未接受膀胱切除术的患者生存率无显著差异（P = 0.65）。局限于器官内的疾病患者生存率略高于非局限于器官内疾病的患者（P = 0.06）。总体、1年、18个月、3年和5年的疾病特异性生存率分别为56%、41%、23%和16%。
尽管过去十年膀胱癌患者的总体生存率有显著提高，但膀胱小细胞癌患者的预后仍然很差。
