Treatment outcomes of small cell carcinoma of the prostate

Abstract

Objective To assess the prevalence and pattern of myocardial fibrosis as detected by delayed enhanced magnetic resonance imaging (DE‐MRI) in patients with systemic sclerosis (SSc), and to evaluate a possible association between myocardial fibrosis and cardiac arrhythmias. Methods Forty‐one patients with SSc underwent 24‐hour Holter monitoring, Doppler echocardiography, and DE‐MRI following gadolinium administration. Results Technically acceptable DE‐MRIs were obtained in 36 patients with SSc. Enhancement on DE‐MRI, consistent with myocardial fibrosis, was observed in 24 of these patients (66%), and it was invariably midwall with a linear pattern, mostly involving basal and midcavity segments of the left ventricle. The volume of enhancement (total volume percentage index [TVPI]) did not differ between patients with diffuse SSc and those with limited SSc (mean ± SD 1.46 ± 1.73% versus 1.44 ± 1.77%; P = 0.98). Patients with a long duration (≥15 years) of Raynaud's phenomenon had a greater number of enhancing segments (mean ± SD 6.55 ± 4.93 versus 2.96 ± 3.46; P = 0.017) and a greater TVPI (mean ± SD 2.44 ± 1.97% versus 1.02 ± 1.43%; P = 0.02) than those with a duration of Raynaud's phenomenon <15 years. Nineteen patients with SSc (53%) had abnormal Holter study results. Compared with patients with normal Holter study results, those with abnormal results had a greater number of enhancing segments (mean ± SD 5.4 ± 4.8 versus 2.5 ± 2.9; P < 0.05) and a greater TVPI (mean ± SD 2.1 ± 1.9% versus 0.8 ± 1.2%; P < 0.05). Conclusion DE‐MRI can identify myocardial fibrosis in a significant percentage of patients with SSc and may be a useful noninvasive tool for determining cardiac involvement.

A comprehensive review of incidence and survival in patients with rare histological variants of prostate cancer in the United States from 1973 to 2008

“…These tumors generally exhibit aggressive behavior similar to their counterparts in the lung and may present with various paraneoplastic syndromes or endocrinopathies. 12 In a review of 83 patients with small cell carcinoma of the prostate by Spiess et al 13 , 75.6% of patients presented with metastatic disease at diagnosis, and the median survival of all patients was 13.1 months. A literature review by Abbas et al 12 found a median survival of 9.8 months and a 5-year OS of 0.9%.…”

Metastatic small cell carcinoma of the prostate in an octogenarian with significant response to first-line chemotherapy

“…In descending order of frequency, men with prostatic SCC most commonly present with voiding, neurologic (confusion, sensory/motor deficits), and/or constitutional symptoms [3]. SCC of the prostate arises in men with pre-existing adenocarcinoma who have received androgen deprivation in nearly half of cases [2,4,5]. This is believed to occur either due to adaptive dedifferentiation of malignant cells under the influence of ADT or the selective pressures of ADT favoring the proliferation of androgen receptor negative neuroendocrine cells [4].…”

“…The majority of patients present with metastatic disease. The most common sites of metastases are the bones, retroperitoneal lymph nodes, liver, lungs, and brain [4]. Therapeutic strategies are largely derived from experience with small cell lung cancer and retrospective reviews as data from randomized controlled trials with prostatic SCC is limited.…”

Pure small cell carcinoma of the prostate: case report

“…Radical prostatectomy alone has been curative in selected patients with small-burdened and early SCPCa. [5] Spiess et al [7] believe that surgical resection with or without radiation therapy combined with chemotherapy should be considered as a treatment strategy in local or early SCPCa. This modality may provide better local control and a potential survival benefit.…”