Patients with small cell carcinoma of the prostate have a poor outcome

November 16, 2007

NEW YORK (Reuters Health) - The prognostic outcome is poor in patients with small cell carcinoma of the prostate, according to results of a study published in the October 15th issue of Cancer. Serum lactate dehydrogenase (LDH) and albumin levels at the time of diagnosis may be predictive of disease-related outcomes.

"Small cell carcinoma (SCC) of the urinary tract is a rare clinical entity, with scant information in the literature regarding its clinical behavior and optimal treatment," Dr. Curtis A. Pettaway and colleagues from the University of Texas M. D. Anderson Cancer Center, Houston, write.

In the current study, the researchers examined the clinical characteristics and prognostic features associated with SCC of the prostate. They identified 83 patients with prostatic SCC between January 1985 and May 2005. The team used univariate and multivariate Cox proportional hazards analyses to determine the impact of the clinical parameters on progression-free survival (PFS) and disease-specific survival (DSS).

Of the 83 patients, 21 (25%) had no evidence of metastatic disease at the time of diagnosis, and 62 patients (75%) had radiologic- or biopsy-proven metastases. Compared to patients with metastatic disease, those with non-metastatic disease were significantly older (median age 63.5 versus 71 years, respectively; p = 0.001). Those with non-metastatic disease also had significantly lower serum LDH level at diagnosis (520 IU/L versus 788 IU/L; p = 0.002).

Disease progressed in 80 patients (96%). The median PFS duration was 6 months. Patients with non-metastatic disease had significantly longer DSS than those with metastatic disease (17.1 months versus 12.5 months (p = 0.03).

After multivariate analysis, only the serum albumin level and log (serum LDH level) were found to be significant predictors of the duration of DSS.

"Patients who present with a low serum albumin level and a high serum LDH level at the time of initial diagnosis appear to have a dismal prognosis and therefore should be offered alternative therapies as soon as possible after symptom control is achieved with conventional chemohormonal therapy," the authors conclude.