Clinicopathological Analysis on Small Cell Carcinoma of the Prostate in Chinese Patients

Abstract

Objective: To explore the clinical and pathological characteristics of small-cell carcinoma (SmCC) of the prostate and applicable treatment methods. Methods: We reported three cases of SmCC of the prostate diagnosed from 1999 to 2011 at the Chinese PLA General Hospital. We also reviewed clinical and pathological data of 26 cases in China reported over the same period. Results: Serum prostate-specific antigen (PSA) levels were normal in 20 cases (76.9%) and elevated in six (23.1%). There was local invasion in 12 cases (46.2%) at the time of diagnosis; lymphatic vessel invasion and distant metastases were detected in eight (30.8%) and nine cases (34.6%) respectively. At the end of follow-up, 16 cases (61.5%) had died, eight (30.8%) survived, and two (7.7%) were missing. The median survival time was 8 months, and the 1-year survival rate was 23.2%. Statistical analysis showed that survival time was significantly correlated with chemotherapy treatment (p<0.05). However, serum PSA levels, surgical approach, pathological type, local invasion, lymphatic vessel invasion, and distant metastasis had no significant relationship with survival (p>0.05). Conclusions: SmCC of the prostate is a rare neoplasm typified by high malignancy, rapid progress, and poor prognosis. Pathological analysis is an important tool for confirming a diagnosis. Pure SmCC is usually not associated with an increase in serum PSA. Surgery, mixed with acinar adenocarcinoma components, and clinical staging do not correlate with prognosis; and chemotherapy was the only prognostic factor. For patients, diagnosed by preoperative biopsy, administering chemotherapy as the first-line treatment may improve outcomes.

Current trend of worsening prognosis of prostate small cell carcinoma: A population‐based study

“…In this study, we stratified the treatments based on summary stage and found that chemotherapy improved the survival of patients with distant/regional metastasis but not patients with localized tumor. These results agreed with the findings of other studies, in which they demonstrated chemotherapy is beneficial to patients with prostate SCC …”

Small Cell Carcinoma of the Prostate in an Elderly Patient: A Case Report and Review of the Literature

“…3,6 Additional randomized trials have explored the addition of other systemic agents with limited to no benefit. 2,10 A research report that explored the clinical and pathological characteristics of SCC of the prostate found statistical evidence that survival time was closely related to chemotherapy administration. The one-year survival rate for patients treated with chemotherapy was 50% while those who did not receive treatment was 9%.…”

“…Other factors, including age, were not statistically significant when correlated with survival time. 2,6 …”

“…Extrapulmonary SCC can be present in multiple organs, and its presence in the prostate accounts for approximately 10% of these cases. 1,2 It was initially described in 1977 by Wenk and colleagues, and remains infrequently discussed within the medical literature. 3,4 Due to its limited incidence, standard treatment guidelines remain undeveloped and most current treatment approaches are based largely on case reports and retrospective review series.…”

“…3,9 The utilization of chemotherapy as the basis of treatment for SCC of the prostate has been well documented, with etoposide/cisplatin regimes derived from the treatment of SCC of the lung showing the greatest efficacy. 2,4,5,10 While the diagnosis of prostate cancer remains common, SCC of the prostate accounts for less than 2%. 4,8 Here, we present the case of an elderly 89-year-old Caucasian male diagnosed with SCC of the prostate following a transurethral resection of the prostate (TURP) procedure for urinary hesitancy.…”