Mp53-09 Impact of Systemic Therapy in Clinical T1 Small-Cell Neuroendocrine Carcinoma of the Bladder

You have accessJournal of UrologyBladder Cancer: Invasive V (MP53)1 May 2024MP53-09 IMPACT OF SYSTEMIC THERAPY IN CLINICAL T1 SMALL-CELL NEUROENDOCRINE CARCINOMA OF THE BLADDER Amanda A. Myers, Andrew M. Fang, Mohammad Jad Moussa, Nathaniel Wilson, Matthew T. Campbell, Charles C. Guo, Miao Zhang, Arlene Siefker-Radtke, Ashish M. Kamat, and Omar Alhalabi Amanda A. MyersAmanda A. Myers , Andrew M. FangAndrew M. Fang , Mohammad Jad MoussaMohammad Jad Moussa , Nathaniel WilsonNathaniel Wilson , Matthew T. CampbellMatthew T. Campbell , Charles C. GuoCharles C. Guo , Miao ZhangMiao Zhang , Arlene Siefker-RadtkeArlene Siefker-Radtke , Ashish M. KamatAshish M. Kamat , and Omar AlhalabiOmar Alhalabi View All Author Informationhttps://doi.org/10.1097/01.JU.0001008784.37684.bd.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Small-cell carcinoma of the bladder (SCCB) carries a poor prognosis due to its high metastatic potential, limited therapeutic options and frequent understaging. Accordingly, patients with clinical (c) T1 SCCB are frequently treated with neoadjuvant chemotherapy (neoCTX). Reports evaluating the impact of neoCTX on cT1 SCCB are lacking. We aimed to analyze survival outcomes and pathologic response of patients with cT1 SCCB treated with neoCTX. METHODS: Following institutional review board approval, all cases of SCCB treated at our institution from January 1996 to July 2023 were identified. cT1N0 was defined as transurethral resection (TUR) pathology showing lamina propria invasion with uninvolved muscularis propria. Patients with no muscle in the TUR specimen and those with muscle-invasion on restaging TUR were excluded. Patients with cT2N0 SCCB were evaluated as a comparator. Median overall survival (mOS) was analyzed using the Kaplan-Meier method. Cox's proportional hazards analysis was used to determine effect on survival. Outcomes associated with neoCTX were evaluated with logistic regression. RESULTS: A total of 30 patients with cT1 SCCB met inclusion criteria. Median follow up was 3.6 years (IQR 2.2-8.5). Median age at diagnosis was 68 (IQR 58-75). Restaging TUR was performed in 21 (70%) patients. NeoCTX was given to 21 (70%) of patients with a median of 4 cycles. Definitive local therapy was performed in 27 (90%) of patients with 24 (80%) cystectomy, 2 radiotherapy, and 1 partial cystectomy. 3 (14%) patients treated with neoCTX relapsed and none developed brain metastasis, while 5 (56%) patients without neoCTX progressed and one developed brain metastasis. In cT1 SCCB, neoCTX was associated with decreased odds of pathologic upstaging (OR 0.05 95%CI 0.0060-0.45) and decreased odds of relapse (OR 0.03 95%CI 0.02-0.8). As compared to cT2, cT1 patients treated with neoCTX had statistically significant improved mOS (219 mo vs 48 mo HR 0.37 95% CI 0.16-0.86). CONCLUSIONS: Patients with cT1 SCCB benefit from neoadjuvant chemotherapy with decreased odds of pathologic upstaging and relapse, and have significantly improved overall survival. To our knowledge, this is the first study to demonstrate that neoadjuvant chemotherapy is associated with improved outcomes for patients with cT1 SCCB. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e866 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Amanda A. Myers More articles by this author Andrew M. Fang More articles by this author Mohammad Jad Moussa More articles by this author Nathaniel Wilson More articles by this author Matthew T. Campbell More articles by this author Charles C. Guo More articles by this author Miao Zhang More articles by this author Arlene Siefker-Radtke More articles by this author Ashish M. Kamat More articles by this author Omar Alhalabi More articles by this author Expand All Advertisement PDF downloadLoading ...