Abstract
Background:
Small-cell carcinoma of the prostate is an aggressive cancer whose rarity has prevented the development of a consensus management approach. The objective of the current study was to determine the treatment patterns and evaluate factors affecting overall survival for patients with localized small-cell carcinoma of the prostate.
Methods:
After querying the National Cancer Database, we identified all patients diagnosed with localized small-cell carcinoma of the prostate between 1998 and 2011 (n=287). Using Kaplan–Meier curves and Cox regression analyses, we assessed the effect of treatment and clinical stage on overall survival.
Results:
Treatments included radiation therapy in 46% (n=131), chemotherapy in 38% (n=107), androgen deprivation therapy (ADT) in 22% (n=63) and radical prostatectomy in 13% (n=38). Median overall survival was 14.8 months. Upon multivariate analysis, local therapy (radical prostatectomy or radiation therapy) was associated with improved survival (hazard ratio (HR) 0.23, 95% confidence interval (CI) 0.14–0.38, P<0.001). Advanced clinical stage predicted worse survival among all men (cT3: HR 2.83, 95% CI 1.27–6.32, P=0.011; cT4: HR 3.26, 95% CI 1.50–7.07, P=0.003) and men who received local therapy (cT3: HR 4.67, 95% CI 1.41–15.44, P=0.012; cT4: HR 4.01, 95% CI 1.14–14.08, P=0.03) but not among men who received no local therapy (cT3: HR 1.64, 95% CI 0.51–5.27, P=0.4; cT4: HR 2.35, 95% CI 0.74–7.48, P=0.15). Age, receipt of chemotherapy and ADT, and clinical stage T2 disease (compared with T1) did not predict survival.
Conclusion:
Men with localized small-cell carcinoma of the prostate have a poor overall survival. Local therapy may represent a suitable and underused modality for select patients.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 4 print issues and online access
$259.00 per year
only $64.75 per issue
Buy this article
- Purchase on SpringerLink
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Tetu B, Ro JY, Ayala AG, Johnson DE, Logothetis CJ, Ordonez NG . Small cell carcinoma of the prostate. Part I. A clinicopathologic study of 20 cases. Cancer 1987; 59: 1803–1809.
Ro JY, Tetu B, Ayala AG, Ordonez NG . Small cell carcinoma of the prostate. II. Immunohistochemical and electron microscopic studies of 18 cases. Cancer 1987; 59: 977–982.
Amato RJ, Logothetis CJ, Hallinan R, Ro JY, Sella A, Dexeus FH . Chemotherapy for small cell carcinoma of prostatic origin. J Urol 1992; 147 (3 Pt 2): 935–937.
Nadal R, Schweizer M, Kryvenko ON, Epstein JI, Eisenberger MA . Small cell carcinoma of the prostate. Nat Rev Urol 2014; 11: 213–219.
Spiess PE, Pettaway CA, Vakar-Lopez F, Kassouf W, Wang X, Busby JE et al. Treatment outcomes of small cell carcinoma of the prostate: a single-center study. Cancer 2007; 110: 1729–1737.
Oesterling JE, Hauzeur CG, Farrow GM . Small cell anaplastic carcinoma of the prostate: a clinical, pathological and immunohistological study of 27 patients. J Urol 1992; 147 (Pt 2): 804–807.
Wang J, Wang FW . Impact of age on clinical presentation, treatment, and cancer-specific survival of patients with small-cell carcinoma of the prostate. Clin Interv Aging 2013; 8: 871–877.
Deorah S, Rao MB, Raman R, Gaitonde K, Donovan JF . Survival of patients with small cell carcinoma of the prostate during 1973-2003: a population-based study. BJU Int 2012; 109: 824–830.
Winchester DP, Stewart AK, Bura C, Jones RS . The National Cancer Data Base: a clinical surveillance and quality improvement tool. J Surg Oncol 2004; 85: 1–3.
Berglund A, Garmo H, Tishelman C, Holmberg L, Stattin P, Lambe M . Comorbidity, treatment and mortality: a population based cohort study of prostate cancer in PCBaSe Sweden. J Urol 2011; 185: 833–839.
Akakura K, Suzuki H, Ichikawa T, Fujimoto H, Maeda O, Usami M et al. A randomized trial comparing radical prostatectomy plus endocrine therapy versus external beam radiotherapy plus endocrine therapy for locally advanced prostate cancer: results at median follow-up of 102 months. Jpn J Clin Oncol 2006; 36: 789–793.
Boorjian SA, Karnes RJ, Viterbo R, Rangel LJ, Bergstralh EJ, Horwitz EM et al. Long-term survival after radical prostatectomy versus external-beam radiotherapy for patients with high-risk prostate cancer. Cancer 2011; 117: 2883–2891.
American Joint Committee on Cancer, (Chicago, IL), Collection System User Documentation and Coding Instructions, version 02.03.02.
Epstein JI, Allsbrook WC Jr., Amin MB, Egevad LL, Committee IG . The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol 2005; 29: 1228–1242.
Anker CJ, Dechet C, Isaac JC, Akerley W, Shrieve DC . Small-cell carcinoma of the prostate. J Clin Oncol 2008; 26: 1168–1171.
Hindson DA, Knight LL, Ocker JM . Small-cell carcinoma of prostate. Transient complete remission with chemotherapy. Urology 1985; 26: 182–184.
Papandreou CN, Daliani DD, Thall PF, Tu SM, Wang X, Reyes A et al. Results of a phase II study with doxorubicin, etoposide, and cisplatin in patients with fully characterized small-cell carcinoma of the prostate. J Clin Oncol 2002; 20: 3072–3080.
Sule-Suso J, Brunt AM . Small cell carcinoma of the prostate. Br J Radiol 1992; 65: 726–728.
Helpap B, Kollermann J . Undifferentiated carcinoma of the prostate with small cell features: immunohistochemical subtyping and reflections on histogenesis. Virchows Arch 1999; 434: 385–391.
Sella A, Konichezky M, Flex D, Sulkes A, Baniel J . Low PSA metastatic androgen- independent prostate cancer. Eur Urol 2000; 38: 250–254.
Lynch SP, Shen Y, Kamat A, Grossman HB, Shah JB, Millikan RE et al. Neoadjuvant chemotherapy in small cell urothelial cancer improves pathologic downstaging and long-term outcomes: results from a retrospective study at the MD Anderson Cancer Center. Eur Urol 2013; 64: 307–313.
Moore SR, Reinberg Y, Zhang G . Small cell carcinoma of prostate: effectiveness of hormonal versus chemotherapy. Urology 1992; 39: 411–416.
Bolton DM, Chiu ST, Clarke S, Angus D . Primary small cell carcinoma of the prostate: unusual modes of presentation. Aust N Z J Surg 1994; 64: 91–94.
Palmgren JS, Karavadia SS, Wakefield MR . Unusual and underappreciated: small cell carcinoma of the prostate. Semin Oncol 2007; 34: 22–29.
Aggarwal R, Zhang T, Small EJ, Armstrong AJ . Neuroendocrine prostate cancer: subtypes, biology, and clinical outcomes. J Natl Compr Cancer Netw 2014; 12: 719–726.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Additional information
Supplementary Information accompanies the paper on the Prostate Cancer and Prostatic Diseases website
Supplementary information
Rights and permissions
About this article
Cite this article
Weiner, A., Patel, S., Richards, K. et al. Population-based analysis of treatment modalities and survival for clinically localized small-cell carcinoma of the prostate. Prostate Cancer Prostatic Dis 17, 286–291 (2014). https://doi.org/10.1038/pcan.2014.26
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/pcan.2014.26