Radical Surgery Compared to Bladder-Preserving Approaches for Limited Stage Small-Cell Bladder Cancer: Systematic
András Kubik1, Isabel Pinto Amorim das Virgens2, Nóra Varga2
1Department of Urology, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Clinical Genitourinary Cancer
|July 15, 2025
Summary
Radiation-based multimodal therapy (RBMMT) shows comparable overall survival to cystectomy-based multimodal therapy (CBMMT) for limited-stage small-cell bladder cancer (SCBC). Bladder-preserving approaches may be a viable option for selected SCBC patients.
Area of Science:
- Oncology
- Urology
Background:
- Small-cell bladder cancer (SCBC) is a rare and aggressive malignancy with no established optimal treatment.
- Limited-stage SCBC management often involves radical surgery or bladder-preserving strategies.
Purpose of the Study:
- To compare the median overall survival (OS) in limited-stage SCBC patients treated with cystectomy-based multimodal therapy (CBMMT) versus radiation-based multimodal therapy (RBMMT).
Main Methods:
- A systematic review and meta-analysis of studies published before January 2024, adhering to PRISMA guidelines.
- Searched databases: PUBMED, Embase, and Scopus.
- Included studies assessing LS-SCBC with survival data for radical surgery or bladder-preserving approaches.
Main Results:
- Analyzed five studies with 1041 patients.
- Pooled median OS: RBMMT (34.6 months) vs. CBMMT (29.7 months).
- Limitations include retrospective study designs and potential bias.
Conclusions:
- RBMMT may offer comparable outcomes to CBMMT in limited-stage SCBC.
- Bladder-preserving approaches (RBMMT) are a consideration for selected patients.
- RBMMT may provide organ preservation benefits without statistically significant survival compromise.
