title: Treatment outcomes of small cell carcinoma of the prostate: a single-center study.
abstract: BACKGROUND
  The current study was conducted to determine the clinical characteristics and prognostic features associated with prostatic small cell carcinoma (SCC).
  
  
  METHODS
  Between January 1985 and May 2005, 83 patients with SCC of the prostate were identified. Univariate and multivariate Cox proportional hazards modeling were used to assess the prognostic significance of the clinical parameters associated with disease-specific outcomes.
  
  
  RESULTS
  Twenty-one patients had no evidence of distant metastasis at the time of the diagnosis of SCC, with the remaining patients demonstrating radiologic or biopsy-proven evidence of metastatic disease. Compared with patients with metastases, patients without metastases at the time of diagnosis were older (P = .001) and had a lower serum lactate dehydrogenase (LDH) level at the time of diagnosis (P = .002). On multivariate analysis, an elevated serum LDH level and low serum albumin at the time of SCC diagnosis was found to be predictive of inferior progression-free survival (P = .02 and P = .008, respectively) and inferior disease-specific survival (DSS) (P = .02 and P = .01, respectively). At the time of last follow-up, 72 patients (87%) had died of disease, with a median DSS duration of 13.1 months (range, 10.7-17.1 months). There was a statistically significant difference noted with regard to the median DSS of patients with nonmetastatic versus those with metastatic SCC (17.7 months [95% confidence interval (95% CI), 12.1-39.2 months] vs 12.5 months [95% CI, 8.1-16.1 months], respectively; P = .03).
  
  
  CONCLUSIONS
  SCC of the prostate is a highly aggressive tumor, with serum LDH and albumin levels at the time of diagnosis believed to be predictive of disease-related outcomes. Although palliative, current systemic therapy does not result in cure and does not provide long-term survival for patients with metastases. For patients with nonmetastatic disease, a strategy utilizing systemic and local therapies should be evaluated further.
authors.affiliation: Department of Urologic Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Philippe E
authors.initials: PE
authors.lastname: Spiess
authors.forename: Curtis A
authors.initials: CA
authors.lastname: Pettaway
authors.forename: Funda
authors.initials: F
authors.lastname: Vakar-Lopez
authors.forename: Wassim
authors.initials: W
authors.lastname: Kassouf
authors.forename: Xuemei
authors.initials: X
authors.lastname: Wang
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Busby
authors.forename: Kim-Anh
authors.initials: KA
authors.lastname: Do
authors.forename: Rajayogesh
authors.initials: R
authors.lastname: Davuluri
authors.forename: Nizar M
authors.initials: NM
authors.lastname: Tannir
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D018288:Carcinoma, Small Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D015996:Survival Rate; D016896:Treatment Outcome