Poorly Differentiated Small-Cell-Type Neuroendocrine Carcinoma of the Prostate: A Case Report and Literature Review

Kumar, Kishore; Ahmed, Rafeeq; Chime, Chukwunonso; Tariq, Hassan; Niazi, Masooma; Makker, Jasbir; Ihimoyan, Ariyo

doi:10.1159/000493255

Cited by 19 publications

(18 citation statements)

References 6 publications

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“…Our study is the most representative and comprehensive of the latest primary survival information of NEC compared with the most common histological type of prostate cancer. Given that NEPC is a rare and highly aggressive malignancy, majority of investigations are based on case reports or retrospective studies limited by small sample sizes (13)(14)(15)(16)(17). Consequently, the present study performed an investigation of a prostate cancer patient cohort based on large population from SEER registries between 2004 and 2018.…”

Section: Discussionmentioning

confidence: 99%

Neuroendocrine Carcinoma as an Independent Prognostic Factor for Patients With Prostate Cancer: A Population-Based Study

et al. 2021

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BackgroundNeuroendocrine carcinoma (NEC) is a rare and highly malignant variation of prostate adenocarcinoma. We aimed to investigate the prognostic value of NEC in prostate cancer.MethodsA total of 530440 patients of prostate cancer, including neuroendocrine prostate cancer (NEPC) and adenocarcinoma from 2004 to 2018 were obtained from the national Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM), multivariable Cox proportional hazard model, Kaplan‐Meier method and subgroup analysis were performed in our study.ResultsNEPC patients were inclined to be older at diagnosis (Median age, 69(61-77) vs. 65(59-72), P< 0.001) and had higher rates of muscle invasive disease (30.9% vs. 9.2%, P < 0.001), lymph node metastasis (32.2% vs. 2.2%, P < 0.001), and distal metastasis (45.7% vs. 3.6%, P < 0.001) compared with prostate adenocarcinoma patients. However, the proportion of NEPC patients with PSA levels higher than 4.0 ng/mL was significantly less than adenocarcinoma patients (47.3% vs. 72.9%, P<0.001). NEPC patients had a lower rate of receiving surgery treatment (28.8% vs. 43.9%, P<0.001), but they had an obviously higher rate of receiving chemotherapy (57.9% vs. 1.0%, P<0.001). A Cox regression analysis demonstrated that the NEPC patients faced a remarkably worse OS (HR = 2.78, 95% CI = 2.34–3.31, P < 0.001) and CSS (HR = 3.07, 95% CI = 2.55–3.71, P < 0.001) compared with adenocarcinoma patients after PSM. Subgroup analyses further suggested that NEPC patients obtained significantly poorer prognosis across nearly all subgroups.ConclusionThe prognosis of NEPC was worse than that of adenocarcinoma among patients with prostate cancer. The histological subtype of NEC is an independent prognostic factor for patients with prostate cancer.

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Section: Discussionmentioning

confidence: 99%

Neuroendocrine Carcinoma as an Independent Prognostic Factor for Patients With Prostate Cancer: A Population-Based Study

et al. 2021

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“…The rarity of primary NEPC means that most available studies to date have been case reports. [7][8][9][10][11] Zaffuto et al 12 Although the difference between the median survival times was statistically significant, this did not translate into a notable clinical difference. Most T-SCNCs present initially as prostate adenocarcinomas, which then undergo neuroendocrine (NE) differentiation.…”

Section: Introductionmentioning

confidence: 99%

“…The rarity of primary NEPC means that most available studies to date have been case reports . Zaffuto et al and Alanee et al explored the differences in prognostic and clinical data between patients with the small‐cell carcinoma (SCC) subtype of NEPC and those with non‐SCC NEPC.…”

Section: Introductionmentioning

confidence: 99%

Low‐serum prostate‐specific antigen level predicts poor outcomes in patients with primary neuroendocrine prostate cancer

Wang

Abudurexiti

et al. 2019

The Prostate

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Background The rarities of primary neuroendocrine prostate cancer (NEPC) and primary adenocarcinoma with neuroendocrine differentiation (NE differentiation) mean that their clinical characteristics have not been fully elucidated. Materials and Methods A total of 449 patients with NEPC, including 352 cases of pure NEPC and 97 cases of NE differentiation, together with 408 629 cases of prostate adenocarcinoma at diagnosis were retrieved from the Surveillance, Epidemiology, and End Results program (2010‐2015). Clinical parameters and prognoses were compared between patients with different histological types of NEPC using the χ2 test and Kaplan‐Meier analysis, respectively. The prognostic value of prostate‐specific antigen (PSA) in NEPC and adenocarcinoma was evaluated using Cox regression and the Kaplan‐Meier method. Results Pure NEPC had higher rates of visceral metastases (brain, lung, and liver: 4.58%, 26.72%, and 36.64%, respectively) but a lower rate of bone metastasis (65.65%) compared with NE differentiation and prostate adenocarcinoma. Moreover, patients diagnosed with pure NEPC had a poorer outcome (median survival time: 10 months) compared with patients with NE differentiation (26 months) and prostate adenocarcinoma (median survival time not reached). Using PSA 4.1 to 10 ng/mL as the reference, the adjusted hazard ratios (HRs) for PSA lower than or equal to 4.0 ng/mL were 2.24 (95% confidence interval [CI]: 1.11‐4.55, P = .025) in the NE differentiation group and 1.57 (95% CI: 1.11‐2.23, P = .011) in the pure NEPC group. Conclusions Patients with NE differentiation had different clinical characteristics and a better prognosis than patients with pure NEPC. In addition, low‐serum PSA levels were associated with a poorer prognosis in patients with either NEPC or NE differentiation.

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“…Our study adds to the existing case reports and cohort studies that have reported on outcomes from other parts of the world 1,13,14 . For example, Horne et al presented on 800 patients with SCPC from the National Cancer Database, US, diagnosed between 2004 and 2015 15 .…”

Section: Discussionmentioning

confidence: 85%

Real-world experience managing unresectable or metastatic small cell carcinoma of the prostate

Adams²,

McMillan³

et al. 2022

CUAJ

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Introduction: Unresectable and metastatic small cell carcinoma of the prostate (SCPC) is a rare and aggressive disease that is under-represented in clinical trials. We carried out a retrospective chart review of metastatic or unresectable SCPC patients at British Columbia (BC) Cancer centers, studying diagnosis and treatment patterns. Methods: Drug dispensing records from the six BC Cancer centers were obtained from 2002–2017. For each patient, information was collected on baseline information prior to therapy, and for each line of treatment. Treatments at each line were compared regarding time to progression and overall survival by Kaplan-Meier curves. Results: Forty-one patients received treatment; 65.6% had metastatic disease and 61% had pure small cell carcinoma. Median time from treatment to death was 10 months (95% confidence interval [CI] 6–16). Patients with initially prostate-confined disease had a better median overall survival (mOS) of 21 months (95% CI 13–34) compared to those with initially locally advanced (mOS 19 months, 95% CI 5–37) and metastatic disease (mOS 8 months, 95% CI 6–10) (log-rank p=0.0364). All patients received either cisplatin- or carboplatin-based combination chemotherapy as the first-line treatment and 36.7% received second-line therapy. Time to second-line therapy was eight months for those who presented with metastatic SCPC, compared to 13 months for those with initial non-metastatic SCPC. Conclusions: This single-province, multi-institution cohort reports data on unresectable and metastatic SCPC and highlights the poor prognosis of this rare disease entity.

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Poorly Differentiated Small-Cell-Type Neuroendocrine Carcinoma of the Prostate: A Case Report and Literature Review

Cited by 19 publications

References 6 publications

Neuroendocrine Carcinoma as an Independent Prognostic Factor for Patients With Prostate Cancer: A Population-Based Study

Neuroendocrine Carcinoma as an Independent Prognostic Factor for Patients With Prostate Cancer: A Population-Based Study

Low‐serum prostate‐specific antigen level predicts poor outcomes in patients with primary neuroendocrine prostate cancer

Real-world experience managing unresectable or metastatic small cell carcinoma of the prostate

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