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

Prostate Cancer Prostatic Dis. 2014 Sep;17(3):286-91. doi: 10.1038/pcan.2014.26. Epub 2014 Jul 15.


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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cause of Death
  • Combined Modality Therapy
  • Databases, Factual
  • Humans
  • Male
  • Middle Aged
  • Mortality
  • Neoplasm Staging
  • Population Surveillance*
  • Proportional Hazards Models
  • Prostatic Neoplasms / diagnosis
  • Prostatic Neoplasms / epidemiology*
  • Prostatic Neoplasms / therapy
  • United States / epidemiology
  • United States / ethnology