Data on small cell cancers of the GU tract from a series of Chinese patients

Small cell carcinoma (SCC) of the prostate is a rare but particularly aggressive and nasty form of prostate cancer. (It can also be found in other genitourinary organs, such as the bladder and the adrenal glands.)

There is no really effective form of treatment for these types of prostate and genitourinary cancers. This has been further confirmed by data from a series of 18 patients with genitourinary SCCs in Chinese patients treated in Shanghai between 2002 and 2012 (recently reported by Chang et al. in the Asian Journal of Andrology). Ten of these patients had SCCs of the prostate.

Chang et al. write that:

  • The average (mean) follow-up for all 18 patients was 15.5 months.
  • The average (mean) progression-free survival (PFS) was 9.3 months.
  • Surgical resection of the tumor was attempted in 13/18 patients (72 percent)
    • 6/14 patients with limited disease had radical surgery (i.e., complete removal of the relevant organ).
  • 13/18 patients (72 percent) were given cisplatin-based chemotherapy.
  • As compared to patients with high lactate dehydrogenase (LDH) levels, patients who had normal LDH levels had a significantly better median PFS and overall survival (OS).
  • As compared to patients who received no surgical treatment, patients with limited disease treated with radical surgery did experience longer PFS.
    • This difference in PFS was not statistically significant (P = 0.211), but …
    • The difference in overall survival of these patients was staistically significant (P = 0.039).

Chang et al. conclude that radical surgery is strongly recommended for patients with genitourinary SCCs, together with cisplatin-based chemotherapy. However, they also not that all their patients have confirmed that SCC has a poor prognosis, and that prognosis is worse in men with elevated LDGH levels above the normal range.

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