Clinicopathological Analysis on Small Cell Carcinoma of the Prostate in Chinese Patients

OBJECTIVE To explore the clinical and pathological characteristics of small-cell carcinoma (SmCC) of the prostate and applicable treatment methods. METHODS We reported three cases of SmCC of the prostate diagnosed from 1999 to 2011 at the Chinese PLA General Hospital. We also reviewed clinical and pathological data of 26 cases in China reported over the same period. RESULTS Serum prostate-specific antigen (PSA) levels were normal in 20 cases (76.9%) and elevated in six (23.1%). There was local invasion in 12 cases (46.2%) at the time of diagnosis; lymphatic vessel invasion and distant metastases were detected in eight (30.8%) and nine cases (34.6%) respectively. At the end of follow-up, 16 cases (61.5%) had died, eight (30.8%) survived, and two (7.7%) were missing. The median survival time was 8 months, and the 1-year survival rate was 23.2%. Statistical analysis showed that survival time was significantly correlated with chemotherapy treatment (p<0.05). However, serum PSA levels, surgical approach, pathological type, local invasion, lymphatic vessel invasion, and distant metastasis had no significant relationship with survival (p>0.05). CONCLUSIONS SmCC of the prostate is a rare neoplasm typified by high malignancy, rapid progress, and poor prognosis. Pathological analysis is an important tool for confirming a diagnosis. Pure SmCC is usually not associated with an increase in serum PSA. Surgery, mixed with acinar adenocarcinoma components, and clinical staging do not correlate with prognosis; and chemotherapy was the only prognostic factor. For patients, diagnosed by preoperative biopsy, administering chemotherapy as the first-line treatment may improve outcomes.