A Limited-Versus-Extensive Staging Strategy for Small Cell Prostate Cancer

Salman Syed, Spyridon P. Basourakos, Faisal S. Ali, Jessica L. Garcia, Amado Zurita-Saavedra, Zimu Gong

Research output: Contribution to journalArticle

Abstract

Introduction:Small cell prostate cancer (SCPC) is a rare histologic subtype of prostate cancer, for which the optimal staging strategy remains unclear.Method:The Surveillance, Epidemiology, and End Results database was used to analyze the incidence and outcomes of SCPC between the years 2004 through 2016. Limited-stage SCPC (LS-SCPC) was defined as SCPC without any metastasis regardless of local invasion. Extensive stage SCPC (ES-SCPC) was defined as any metastasis to lymph nodes and/or to distant organs.Result:A total of 403 SCPC patients were included in the study cohort, accounting for 0.056% of all prostate cancer cases (n=719,655). Of the 358 patients with known metastasis status, 275 (76.8%) patients had ES-SCPC, whereas 83 (23.2%) patients had LS-SCPC. LS-SCPC was associated with better overall survival (17 vs. 9 mo, P<0.001) and disease-specific survival (25 vs. 10 mo, P<0.001) compared with ES-SCPC. All LS-SCPC patients had a similar overall survival regardless of T stage. Similarly, all ES-SCPC patients had similar outcomes regardless of metastasis sites. High prostate-specific antigen (PSA) is paradoxically associated with superior outcome in both localized stage patients (PSA≥4 vs. PSA<4, 19 vs. 10 mo, P=0.002) and extensive stage patients (PSA≥20 vs. PSA<20, 13 vs. 9 mo, P=0.02). Multivariate analysis of treatment showed that chemotherapy was associated with improved survival in ES-SCPC with hazard ratio of 0.52.Conclusion:Similar to small cell lung cancer, SCPC can be staged into LS-SCPC or ES-SCPC. The binary staging system correlates well with prognosis.

Original languageEnglish (US)
Pages (from-to)87-93
Number of pages7
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume43
Issue number2
DOIs
StatePublished - Feb 1 2020

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Prostatic Neoplasms
Prostate-Specific Antigen
Neoplasm Metastasis
Survival
Small Cell Lung Carcinoma
Epidemiology
Cohort Studies
Multivariate Analysis
Lymph Nodes
Databases
Drug Therapy
Incidence

Keywords

  • epidemiology
  • neuroendocrine tumor
  • prostate cancer
  • prostate-specific antigen
  • small cell cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

A Limited-Versus-Extensive Staging Strategy for Small Cell Prostate Cancer. / Syed, Salman; Basourakos, Spyridon P.; Ali, Faisal S.; Garcia, Jessica L.; Zurita-Saavedra, Amado; Gong, Zimu.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 43, No. 2, 01.02.2020, p. 87-93.

Research output: Contribution to journalArticle

Syed, Salman ; Basourakos, Spyridon P. ; Ali, Faisal S. ; Garcia, Jessica L. ; Zurita-Saavedra, Amado ; Gong, Zimu. / A Limited-Versus-Extensive Staging Strategy for Small Cell Prostate Cancer. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 2020 ; Vol. 43, No. 2. pp. 87-93.
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AU - Syed, Salman

AU - Basourakos, Spyridon P.

AU - Ali, Faisal S.

AU - Garcia, Jessica L.

AU - Zurita-Saavedra, Amado

AU - Gong, Zimu

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N2 - Introduction:Small cell prostate cancer (SCPC) is a rare histologic subtype of prostate cancer, for which the optimal staging strategy remains unclear.Method:The Surveillance, Epidemiology, and End Results database was used to analyze the incidence and outcomes of SCPC between the years 2004 through 2016. Limited-stage SCPC (LS-SCPC) was defined as SCPC without any metastasis regardless of local invasion. Extensive stage SCPC (ES-SCPC) was defined as any metastasis to lymph nodes and/or to distant organs.Result:A total of 403 SCPC patients were included in the study cohort, accounting for 0.056% of all prostate cancer cases (n=719,655). Of the 358 patients with known metastasis status, 275 (76.8%) patients had ES-SCPC, whereas 83 (23.2%) patients had LS-SCPC. LS-SCPC was associated with better overall survival (17 vs. 9 mo, P<0.001) and disease-specific survival (25 vs. 10 mo, P<0.001) compared with ES-SCPC. All LS-SCPC patients had a similar overall survival regardless of T stage. Similarly, all ES-SCPC patients had similar outcomes regardless of metastasis sites. High prostate-specific antigen (PSA) is paradoxically associated with superior outcome in both localized stage patients (PSA≥4 vs. PSA<4, 19 vs. 10 mo, P=0.002) and extensive stage patients (PSA≥20 vs. PSA<20, 13 vs. 9 mo, P=0.02). Multivariate analysis of treatment showed that chemotherapy was associated with improved survival in ES-SCPC with hazard ratio of 0.52.Conclusion:Similar to small cell lung cancer, SCPC can be staged into LS-SCPC or ES-SCPC. The binary staging system correlates well with prognosis.

AB - Introduction:Small cell prostate cancer (SCPC) is a rare histologic subtype of prostate cancer, for which the optimal staging strategy remains unclear.Method:The Surveillance, Epidemiology, and End Results database was used to analyze the incidence and outcomes of SCPC between the years 2004 through 2016. Limited-stage SCPC (LS-SCPC) was defined as SCPC without any metastasis regardless of local invasion. Extensive stage SCPC (ES-SCPC) was defined as any metastasis to lymph nodes and/or to distant organs.Result:A total of 403 SCPC patients were included in the study cohort, accounting for 0.056% of all prostate cancer cases (n=719,655). Of the 358 patients with known metastasis status, 275 (76.8%) patients had ES-SCPC, whereas 83 (23.2%) patients had LS-SCPC. LS-SCPC was associated with better overall survival (17 vs. 9 mo, P<0.001) and disease-specific survival (25 vs. 10 mo, P<0.001) compared with ES-SCPC. All LS-SCPC patients had a similar overall survival regardless of T stage. Similarly, all ES-SCPC patients had similar outcomes regardless of metastasis sites. High prostate-specific antigen (PSA) is paradoxically associated with superior outcome in both localized stage patients (PSA≥4 vs. PSA<4, 19 vs. 10 mo, P=0.002) and extensive stage patients (PSA≥20 vs. PSA<20, 13 vs. 9 mo, P=0.02). Multivariate analysis of treatment showed that chemotherapy was associated with improved survival in ES-SCPC with hazard ratio of 0.52.Conclusion:Similar to small cell lung cancer, SCPC can be staged into LS-SCPC or ES-SCPC. The binary staging system correlates well with prognosis.

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KW - neuroendocrine tumor

KW - prostate cancer

KW - prostate-specific antigen

KW - small cell cancer

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