Small cell cancer (SCC) of bladder comprise of only 0.35% -0.7% of all bladder tumors. It is associated with a median survival of 19.6 months for all stages in view of its aggressive course, presentation at later stages and with larger tumors. SCC of bladder has no standard treatment and current management is based on SCC lung protocols.
We report here a retrospective analysis of the management of SCC bladder at our institute.

Between the period of 2014 to 2018, 12 patients with histopathological diagnosis of SCC bladder were identified and data was available for 10 patients. Data regarding patient demographics, smoking history, performance status, stage (limited/extensive), treatment received and outcome was obtained. Survival was estimated as the time from diagnosis of SCC bladder to death or the last follow up. Survival curves were generated using the Kaplan Meier curves.

Data was available for 10 patients. Most of the patients were males (9/10) and smokers (8/10) with a median age of 59 years. Most patients had good ECOG performance status of 0-1 (8/10) and presented with limited stage disease (9/10).  The only patient with extensive disease was a non smoker female presenting with involvement of cervix and vagina. All patients presented with hematuria and underwent TURBT. Post TURBT, treatment was at surgeon’s discretion. One patient received chemoradiotherapy without undergoing radical cystectomy, three received chemotherapy only. Three patients received neoadjuvant chemotherapy followed by radical cystectomy and one patient underwent upfront cystectomy. Two patients underwent TURBT only.The mean follow up period was 20.6 months. Four patients were alive till the last follow up amongst which two had received neoadjuvant chemotherapy followed by cystectomy, one only completion TURBT and one only chemotherapy.  The overall median survival was 14 months.

Data was available for 10 patients. Most of the patients were males (9/10) and smokers (8/10) with a median age of 59 years. Most patients had good ECOG performance status of 0-1 (8/10) and presented with limited stage disease (9/10).  The only patient with extensive disease was a non smoker female presenting with involvement of cervix and vagina. All patients presented with hematuria and underwent TURBT. Post TURBT, treatment was at surgeon’s discretion. One patient received chemoradiotherapy without undergoing radical cystectomy, three received chemotherapy only. Three patients received neoadjuvant chemotherapy followed by radical cystectomy and one patient underwent upfront cystectomy. Two patients underwent TURBT only.The mean follow up period was 20.6 months. Four patients were alive till the last follow up amongst which two had received neoadjuvant chemotherapy followed by cystectomy, one only completion TURBT and one only chemotherapy.  The overall median survival was 14 months.

SCC of bladder is a rare aggressive tumor affecting the eldery smokers. The prognosis is influenced by performance status, extent of disease and use of chemotherapy either in neoadjuvant or adjuvant setting. For young patients, cystectomy with chemotherapy offers better survival as compared to chemoradiation alone.