Prostate Cancer Coverage from Every Angle

Small Cell Carcinoma of the Prostate: Update on Patterns of Care

By: Joseph Fanelli
Posted: Thursday, October 31, 2019

For patients diagnosed with small cell carcinoma of the prostate, recent findings published in The Prostate indicate that radiotherapy to the prostate may provide survival benefits in nonmetastatic cases, although chemotherapy remains the “cornerstone” treatment. The National Cancer Database (NCDB) analysis, reportedly the largest to date of the rare disease, also found that androgen-deprivation therapy may be beneficial to patients with an elevated prostate‐specific antigen (PSA) value.

“Our multivariable analysis suggests that if radiotherapy is going to be utilized, doses greater than 50 Gy should be considered,” noted April L. Metzger, MD, of the Allegheny Health Network, Pittsburgh, and colleagues. “This agrees with the general principle of [small cell carcinoma] being a systemic disease with chemotherapy as the mainstay of treatment and radiation used for local control/survival benefit as opposed to surgery.”

Investigators utilized the NCDB to identify 657 patients with small cell carcinoma and neuroendocrine of the prostate. Most of the patients included had positive lymph nodes (60%) and metastatic disease (70%).

The median survival among these patients was 12 months, with a median follow-up of 11.8 months. The authors found that metastatic disease, age of 70 and older, omission of androgen-deprivation therapy, and lower income were all associated with reduced overall survival. Those patients who had PSA levels greater than or equal to 33 ng/mL and persons who received androgen-deprivation therapy seemed to experience better survival outcomes (P < .05).

According to the study authors, patients diagnosed with nonmetastatic disease were more likely to undergo prostatectomy and/or prostatic or pelvic radiation (P < .0001). In addition, prostatic or pelvic radiation in nonmetastatic cases was associated with longer survival (P = .02).

Disclosure: The study authors reported no conflicts of interest.

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