Neuroendocrine Prostate Cancer (NEPC) Progressing From Conventional Prostatic Adenocarcinoma: Factors Associated With Time to Development of NEPC and Survival From NEPC Diagnosis—A Systematic Review and Pooled Analysis
Top Cited Papers
- 20 October 2014
- journal article
- review article
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 32 (30), 3383-3390
- https://doi.org/10.1200/jco.2013.54.3553
Abstract
An often under-recognized late manifestation of prostate adenocarcinoma (PCa) is the development of treatment-related neuroendocrine prostate cancer (NEPC). The aim of this study is to identify the risk factors related to survival after NEPC diagnosis (NEPCS) and time from initial diagnosis of PCa to development of NEPC (TTNEPC). A literature search on NEPC was performed using databases such as MEDLINE and EMBASE. Studies were eligible if outcomes data (NEPCS and/or TTNEPC) were reported in patients with a prior history of PCa and histopathologically confirmed NEPC. NEPCS and TTNEPC were evaluated using the Cox regression model with the robust sandwich estimates of the covariance matrix. There were 54 eligible publications, contributing 123 patients. The median TTNEPC was 20 months. In multivariable analyses, the Gleason score was significantly associated with shorter TTNEPC (hazard ratio [HR], 1.66; P = .032). The median NEPCS was 7 months. In multivariable analyses, the number of organs with metastatic disease at NEPC was significantly associated with shorter NEPCS (HR, 3.31; P = .001). Type of treatment after NEPC was significantly associated with longer NEPCS, with HRs of 0.66 (radiotherapy v palliative therapy; P = .034), 0.38 (chemotherapy v palliative therapy; P = .018), and 0.29 (chemoradiotherapy v palliative therapy; P = .012), respectively. Treatment-related NEPC is an often under-recognized late manifestation of PCa with poor prognosis. Our study found that Gleason score was the only independent factor contributing to TTNEPC. Once NEPC is diagnosed, type of treatment and the number of organs with metastatic disease were the most important factors related to survival.Keywords
This publication has 57 references indexed in Scilit:
- A 45-Year-Old With Neuroendocrine Carcinoma of the ProstateUrology, 2013
- Cancer statistics, 2013CA: A Cancer Journal for Clinicians, 2013
- A useful treatment for patients with advanced mixed-type small cell neuroendocrine carcinoma of the prostate: A case reportOncology Letters, 2013
- Small cell carcinoma of the prostate after high-dose-rate brachytherapy for low-risk prostatic adenocarcinomaOncology Letters, 2012
- From sequence to molecular pathology, and a mechanism driving the neuroendocrine phenotype in prostate cancerThe Journal of Pathology, 2012
- Molecular Characterization of Neuroendocrine Prostate Cancer and Identification of New Drug TargetsCancer Discovery, 2011
- Cancer mortality in Europe, 2000–2004, and an overview of trends since 1975Annals Of Oncology, 2009
- Small-cell prostate carcinoma: A retrospective analysis of five newly reported casesIndian Journal of Urology, 2009
- Paraneoplastic Cushing’s syndrome in prostate cancer: a difficult management problemBJU International, 2007