| Autor: |
Ullah A; Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA., Yasinzai AQK; University of Florida Health Cancer Center, Gainesville, FL 32608, USA., Lee KT; Medical College of Georgia, Augusta, GA 30912, USA., Chaudhury T; Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA., Chaudhury H; Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA., Chandasir A; Medical College of Georgia, Augusta, GA 30912, USA., Wali A; Bolan Medical College, Quetta 83700, Pakistan., Waheed A; Department of Surgery, Baycare Health System, Clearwater, FL 33759, USA., Tareen B; Bolan Medical College, Quetta 83700, Pakistan., Khan M; Marshfield Clinics, Marshfield, WI 54449, USA., Goyal A; Seth GS Medical College and KEM Hospital, Mumbai 400012, India., Iqbal A; Mercy Hospital, Ardmore, OK 73401, USA., Sohail AH; Department of Surgery, University of New Mexico, Albuquerque, NM 87106, USA., Maan S; Department of Internal Medicine, West Virginia University, Morgantown, WV 26506, USA., Sheikh AB; Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA., Ghafouri SAR; Department of Hematology-Oncology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA., Khan I; Department of Medicine, Insight Hospital and Medical Center, Chicago, IL 60616, USA., Del Rivero J; Division of Medical Oncology, National Institute of Health (NIH), Bethesda, MD 20814, USA., Karki NR; Mitchell Cancer Institute, University of South Alabama, Mobile, AL 36604, USA. |
| Abstrakt: |
Background : This retrospective study aims to examine the patient demographics, survival rates, and treatment methods for small-cell neuroendocrine carcinoma (SCNEC) and large-cell neuroendocrine carcinoma (LCNEC) of prostate origin while also identifying the main differences between common types of prostate cancer with comparative analysis for survival. Methods : Our analysis utilized the Surveillance, Epidemiology, and End Results database (SEER), and data was collected from 2000-2020. Cox proportional hazards and chi-squared analysis were used for statistical analysis. Results : A total of 718 cases of prostate small and large neuroendocrine carcinoma were identified. The median age was 71.5 years, and the median follow-up was 11.0 years (95% confidence interval (95% CI) = 9.2-12.8). Most patients were over the age of 80 years (33.8%) and Caucasian (74.4%). The overall 5-year survival was 8.0% (95% CI = 6.8-9.2). The 5-year OS for Caucasians was 7.3% (95% C.I. 6.0-8.3). For Black Americans, the 5-year OS was 11.9% (95% C.I. 7.3-16.5). For Hispanics, the 5-year OS was 12.2% (95% C.I. 7.7-16.7). The 5-year cause-specific survival (CSS) was 16.2% (95% CI = 14.3-18.1). For treatment modality, the five-year survival for each were as follows: chemotherapy, 3.5% (95% CI = 2.1-4.9); surgery, 18.2% (95% CI = 13.6-22.8); multimodality therapy (surgery and chemotherapy), 4.8% (95% CI = 1.7-7.9); and combination (chemoradiation with surgery), 5.0% (95% CI = 1.0-9.0). The prognostic nomogram created to predict patient survivability matched the findings from the statistical analysis with a statistical difference found in race, income, housing, stage, and nodal status. The nomogram also indicated a slight increase in mortality with tumors of greater size. This analysis showed a slight increase in mortality for patients of Asian race. In addition, there was a significant increase in death for patients with stage 3 tumors, as well as patients who underwent surgery and radiation. Furthermore, we performed propensity score matching for survival differences, and no survival difference was found between SCNEC and LCNEC. Conclusions : Asian patients, larger tumor size, and distant disease were associated with worse long-term clinical outcomes. By leveraging insights from registry-based studies, clinicians can better strategize treatment options, improving patient outcomes in this challenging oncology arena. |
