[ XXXX : our experience].

@entity1 @entity4153 @entity66 @entity146 @entity5 @entity548 @entity1442 @entity150 @entity3 @entity811 @entity902
INTRODUCTION: Neuroendocrine @entity150 is extremely rare, with an estimated incidence of 0.35-0.70% of all @entity150 . The @entity4153 represents the most frequent histologic variant described. @entity4153 is an @entity5 associated with a more @entity146 and poorer prognosis than transitional cell @entity150 . The overall survival rate at 5 years does not exceed 8%. At the time of presentation 59% of @entity1 have clinical stage >T2 and 56% show @entity3 . In 50% of the @entity1 , fatal progression occurs within 6 months. Local recurrence after radical surgery occurred in 50-70% of cases. @entity1 AND METHODS: We report three cases of pure @entity150 . @entity811 was the most common presenting symptom. @entity1442 was present in all the cases with stage >T2, @entity3 in 1 case, lymph node involvement and ureteral bilateral obstruction in 2. Two @entity1 were treated by radical cystectomy, bilateral pelvic limph node resections and urinary derivation. @entity902 -based adjuvant chemotherapy was proposed but only two @entity1 received the treatment. One @entity1 with liver @entity3 was managed only by extensive TUR and support regimen. RESULTS: In 2 @entity1 residual or relapsed @entity5 reappered within 2 months after surgery. All of the three @entity1 died of @entity3 at 5, 7, and 13 months. Median overall survival was 7 months. The most common site of relapse and @entity66 was the peritoneum and intestinal tract, and the reason of death was uncontrolled acute @entity548 from gastro-intestinal district. CONCLUSIONS: In the absence of a prospective study, and because of the rarity of the disease, the best treatment for small-cell @entity150 remains uncertain. Neoadjuvant chemotherapy with @entity902 regimen plus aggressive surgical approach will be the treatment of choice. The association of chemotherapy and radiotherapy should also be considered.
