Population-based analysis of treatment modalities and survival for clinically localized small-cell carcinoma of the prostate

Background: Small-cell carcinoma of the prostate is an aggressive cancer whose rarity has prevented the development of a consensus management approach. The objective of the current study was to determine the treatment patterns and evaluate factors affecting overall survival for patients with localized small-cell carcinoma of the prostate. Methods: After querying the National Cancer Database, we identified all patients diagnosed with localized small-cell carcinoma of the prostate between 1998 and 2011 ( n =287). Using Kaplan–Meier curves and Cox regression analyses, we assessed the effect of treatment and clinical stage on overall survival. Results: Treatments included radiation therapy in 46% ( n =131), chemotherapy in 38% ( n =107), androgen deprivation therapy (ADT) in 22% ( n =63) and radical prostatectomy in 13% ( n =38). Median overall survival was 14.8 months. Upon multivariate analysis, local therapy (radical prostatectomy or radiation therapy) was associated with improved survival (hazard ratio (HR) 0.23, 95% confidence interval (CI) 0.14–0.38, P