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Clinical Research

Population-based analysis of treatment modalities and survival for clinically localized small-cell carcinoma of the prostate

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.

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Correspondence to S E Eggener.

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Supplementary Information accompanies the paper on the Prostate Cancer and Prostatic Diseases website

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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

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  • DOI: https://doi.org/10.1038/pcan.2014.26

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