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Program

WSU Medical School

Training Level

Medical Student

Institution

Wayne State University

Abstract

Background: Neuroendocrine (NEC) carcinoma is a rare variant of prostate adenocarcinoma (PCa) associated with advanced local stage, high incidence of metastatic disease, and poor survival. It is also associated with marked enlargement of prostate, for which some men with localized disease get local therapy in the form of radical prostatectomy (RP). The prognostic significance of positive surgical margin (PSM) after RP in this scenario is unknown. Our aim was to address this void in literature. Methods: We focused on 92 patients aged >= 18 years diagnosed with nonmetastatic NEC, and who underwent radical prostatectomy between 2004 and 2015 within the NCDB. Overall survival (OS) in those with PSM was compared to those who with negative surgical margin (NSM) using Kaplan-Meier survival analyses. Cox proportional hazards model—adjusted for age, race, local tumor stage, and charlson comorbidity score—was then used to test the effect of PSM on overall mortality.Results:The median age of the cohort was 63 years (IQR 59-69). Advanced local stage >= T3 was present in 27 (29%) patients. PSM were present in 42 (45%) patients; NSM in 50 (54%) patients. Median follow up in patients with PSM was 27 months compared to 54 months in the NSM group. At median follow up, the OS in patients with NSM was 73%, compared to 56% in PSM group. Unadjusted Kaplan Meier survival curves are shown in figure 1. After adjustment for confounders, PSM group had a higher overall mortality (HR 3.0; CI 1.4-6.6; p=0.007) compared to the NSM group. Conclusions: In surgically treated nonmetastatic NEC PCa, PSM are associated with a higher overall mortality independent of age, local tumor stage, and comorbidities. Source of funding: None Conflict of interest: None Category list: Prostate cancer Key words: Prostate neoplasms; neuroendocrine carcinoma; small cell carcinoma, radical prostatectomy; surgical margins

Publication Date

5-2019

Impact of positive surgical margins on overall mortality in localized neuroendocrine carcinoma of prostate treated with radical prostatectomy

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