Contemporary Incidence and Cancer Control Outcomes of Primary Neuroendocrine Prostate Cancer: A SEER Database Analysis

医学 危险系数 前列腺癌 置信区间 前列腺切除术 内科学 入射(几何) 比例危险模型 肿瘤科 流行病学 监测、流行病学和最终结果 混淆 癌症 癌症登记处 光学 物理
作者
Emanuele Zaffuto,Raisa S. Pompe,Marc Zanaty,Helen Davis Bondarenko,Sami‐Ramzi Leyh‐Bannurah,Marco Moschini,Paolo Dell’Oglio,Giorgio Gandaglia,Nicola Fossati,Armando Stabile,Kevin C. Zorn,Francesco Montorsi,Alberto Briganti,Pierre I. Karakiewicz
出处
期刊:Clinical Genitourinary Cancer [Elsevier BV]
卷期号:15 (5): e793-e800 被引量:51
标识
DOI:10.1016/j.clgc.2017.04.006
摘要

Neuroendocrine carcinoma of the prostate (NEPC) is a rare entity. We aimed at providing contemporary data on incidence and survival figures of de-novo NEPC.Within the Surveillance, Epidemiology, and End Results (SEER) database, we identified 309 individuals with de-novo NEPC diagnosed between 2004 and 2013. We evaluated age-adjusted incidence rates over the study. Kaplan-Meier analyses assessed overall survival (OS) after stratification according to histologic subtype, metastatic status, and treatment. Cox regression analyses tested the predictors of overall mortality, after adjusting for confounders.A total of 309 cases of NEPC were identified from 510,913 cases of prostate cancer. Metastatic disease was identified in 198 (64.1%) cases. The most common histologic subtype (n = 186; 60.2%) was small-cell carcinoma (SCC). The age-adjusted incidence of NEPC significantly increased over the study span. However, this increase only affected SCC (from 0.13/1,000,000 person-years in 2004 to 0.30/1,000,000 person-years in 2013; P = .001). Median survival for NEPC was 10 months. After stratification by metastatic status, no difference was observed according to SCC versus non-SCC. Treatment with radical prostatectomy improved OS only among individuals with non-metastatic disease, whereas radiation therapy did not affect OS rates. In multivariable Cox regression analyses predicting overall mortality, metastatic stage (hazard ratio, 1.52; 95% confidence interval, 1.12-2.06; P < .01) and radical prostatectomy (hazard ratio, 0.38; 95% confidence interval, 0.20-0.74; P < .01) achieved independent predictor status.De-novo NEPC is extremely rare and will be encountered in clinical practice by few urologists. Most cases are metastatic at diagnosis. Prognosis is poor regardless of histologic type, especially in metastatic stage.
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