Prognostic Nomogram, Demographics and Comparative Analysis of Urinary Bladder Small Cell and Large Cell Neuroendocrine Carcinoma

Asad Ullah ¹, Kue Tylor Lee ², Hannah Chaudhury ¹

⁰Texas Tech University Health Sciences Center, Lubbock, TX.

Clinical Genitourinary Cancer +

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September 5, 2024

View abstract on PubMed

Summary

Small-cell (SCNEC) and large-cell (LCNEC) neuroendocrine bladder cancers are aggressive, rare tumors. Older age and positive nodal status are poor prognostic indicators for these bladder cancers.

Area Of Science

Urology
Oncology
Pathology

Background

Small-cell neuroendocrine carcinoma (SCNEC) and large-cell neuroendocrine carcinoma (LCNEC) are rare, aggressive bladder cancer subtypes.
These subtypes differ significantly from common urothelial bladder cancers.

Purpose Of The Study

To analyze the demographics, survival rates, and treatment approaches for SCNEC and LCNEC.
To identify key differences between SCNEC/LCNEC and common bladder cancers.
To provide insights for improved clinical guidelines and tailored treatment strategies.

Main Methods

Retrospective analysis of the Surveillance, Epidemiology, and End Results (SEER) database.
Data collected from 2000-2020, encompassing 1040 cases of urinary bladder SCNEC and LCNEC.
Multivariable analysis to identify prognostic indicators.

Main Results

The majority of patients were Caucasian males over 80 years old, with tumors larger than 4.1cm located in the lateral bladder wall.
Overall 5-year survival was 22.1%, with higher survival rates observed in females.
Multimodality therapy (surgery and chemotherapy) and combination therapy (surgery, chemotherapy, radiation) showed improved 5-year survival rates (31.1% and 32.8%, respectively) compared to surgery alone (12.5%).
Positive nodal status (HR 3.65) and increasing age were significant negative predictors of survival.

Conclusions

SCNEC and LCNEC are rare, aggressive bladder cancers predominantly affecting elderly Caucasian males.
Older age and positive nodal status are adverse prognostic indicators for these rare bladder cancers.
Findings support the need for tailored treatment strategies and inform future clinical guidelines for SCNEC and LCNEC.

Keywords:

Multimodal therapy Multivariate analysis SEER Survival Urinary bladder