title: [Androgen-deprivation therapy in the management of neuroendocrine prostate cancer].
abstract: BACKGROUND
  Prostatic neuroendocrine carcinomas comprise <1% of all prostate neoplasms, and approximately 200 cases have been reported in the literature. We undertook this study to describe the experience in the management of prostatic neuroendocrine carcinoma with androgen-deprivation therapy (ADT).
  
  
  METHODS
  We designed a retrospective, descriptive and observational study. In patients with suspicion of prostate cancer, transrectal ultrasonography-guided biopsy (TRUS) or transurethral resection of prostate (TURP) was carried out during the period from January 2000 to December 2007. Patients were selected by anatomopathological diagnostic study of neuroendocrine carcinoma including pure and mixed variants. Characteristics analyzed were age, clinical stage, prostate-specific antigen (PSA), imaging studies, treatment and survival.
  
  
  RESULTS
  Ten cases were included with a median age of 66.5 years. Symptoms at diagnosis were associated with metastasis to other organs, one with bone metastasis, and presenting pain in 100% of the cases. A suspicious rectal digital examination was detected in 100% of the patients. In three (30%) patients, PSA was suspicious for prostate cancer. The extension studies showed bone, locoregional, lung and hepatic metastases. In six (60%) patients mixed variant was documented (acinar adenocarcinoma and neuroendocrine carcinoma) with a median survival of 11.6 months. In four patients (40%), pure neuroendocrine carcinoma was documented with a median survival of 7 months.
  
  
  CONCLUSIONS
  Prostatic neuroendocrine carcinoma is uncommon, aggressive and represents a prostatic neoplasia without PSA expression. In advanced disease, very low response is reached with ADT.
authors.affiliation: Servicio de Urología Oncológica, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., Mexico. andres2424@yahoo.com
authors.forename: Andrés
authors.initials: A
authors.lastname: Martínez-Cornelio
authors.forename: Juventino
authors.initials: J
authors.lastname: González-Pérez
authors.forename: Felipe de Jesús
authors.initials: Fde J
authors.lastname: Tabares-García
authors.forename: Francisco
authors.initials: F
authors.lastname: Ramos-Salgado
authors.forename: Isabel
authors.initials: I
authors.lastname: Alvarado-Cabrero
authors.forename: Narciso
authors.initials: N
authors.lastname: Hernández-Toriz
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D000726:Androgen Antagonists