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Open AccessArticle

Perioperative Chemotherapy in Poorly Differentiated Neuroendocrine Neoplasia of the Bladder: A Multicenter Analysis

1
Department of Experimental, Diagnostic and Specialty Medicine, S.Orsola-Malpighi University Hospital, 40138 Bologna, Italy
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AOU S.Luigi Gonzaga, 10043 Orbassano (Torino), Italy
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Department of Medical Oncology, Fondazione IRCCS Istituto Tumori Milano, ENETS Center of Excellence, 20133 Milan, Italy
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Department of Oncology and Hematology, University Hospital of Modena, 41125 Modena, Italy
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Division of Medical Oncology, Ospedale Centrale di Bolzano, 39100 Bolzano, Italy
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Division of Oncology, S.Orsola-Malpighi Hospital, 40138 Bologna, Italy
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Medical Oncology, Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, 90127 Palermo, Italy
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Oncologia - AORN Cardarelli, 80131 Naples, Italy
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Osteoncology and Rare Tumors Center- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCSS, 47014 Meldola (Forlì-Cesena), Italy
10
Medical Oncology, Azienda Ospedaliera Universitaria Integrata, University of Verona, 37126 Verona, Italy
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Fondazione Policlinico «A. Gemelli» IRCCS, 00168 Roma, Italy
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Medical Oncology Unit, University Hospital of Parma, 43126 Parma, Italy
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Digestive Disease Unit, Sant’Andrea University Hospital, ENETS Center of Excellence, 00189 Rome, Italy
14
Department of Medical and Surgical Sciences, S.Orsola-Malpighi University Hospital, 40138 Bologna, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(5), 1351; https://doi.org/10.3390/jcm9051351
Received: 28 March 2020 / Revised: 23 April 2020 / Accepted: 28 April 2020 / Published: 5 May 2020
(This article belongs to the Special Issue Neuroendocrine Tumors: Clinical Challenges)
There is scant evidence about optimal management of poorly differentiated neuroendocrine carcinoma of the bladder (BNEC). We performed a multicenter retrospective study on BNEC patients from 13 Italian neuroendocrine-dedicated centers to analyze strategies associated with better outcomes. Mixed adeno-neuroendocrine carcinomas (MANEC) were included. We analyzed overall survival (OS) in the overall cohort, relapse-free survival (RFS) in radically operated patients and progression-free survival (PFS) in patients who received chemotherapy for metastatic disease. Fifty-one BNEC patients were included (male: 46, median age: 70 years). Overall, median OS was 16.0 months, radical tumor resection was performed in 37 patients (72.5%) and 11 of these (29.7%) also received peri-operative platinum-etoposide chemotherapy. Median OS was longer in patients with better performance status (PS) and in those with stage I–III disease at diagnosis compared to stage IV. Among patients who underwent radical tumor resection (N = 37), RFS was longer in patients with better PS and showed a trend towards a longer RFS in those treated with peri-operative chemotherapy than with surgery alone (11 vs. 6 months; p = 0.078). Among 28 patients receiving chemotherapy for metastatic disease, PFS was 5.0 months and there was a trend towards improved PFS in patients receiving carboplatin-etoposide chemotherapy compared to other regimens. A multivariate model unmasked a significant association between carboplatin-etoposide chemotherapy and risk for disease progression or death (HR: 0.39 (95%CI: 0.16–0.96) p = 0.040). Performance status might be associated with improved RFS in radically operated patients, while type of chemotherapy might affect PFS in patients receiving chemotherapy for metastatic BNEC. View Full-Text
Keywords: neuroendocrine carcinoma (NEC); perioperative chemotherapy; bladder; disease-specific survival; prognostic factors; small cell carcinoma neuroendocrine carcinoma (NEC); perioperative chemotherapy; bladder; disease-specific survival; prognostic factors; small cell carcinoma
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Lamberti, G.; Brizzi, M.P.; Pusceddu, S.; Gelsomino, F.; Di Meglio, G.; Massari, F.; Badalamenti, G.; Riccardi, F.; Ibrahim, T.; Ciccarese, C.; Buti, S.; Carnaghi, C.; Prinzi, N.; Panzuto, F.; Campana, D. Perioperative Chemotherapy in Poorly Differentiated Neuroendocrine Neoplasia of the Bladder: A Multicenter Analysis. J. Clin. Med. 2020, 9, 1351.

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