PDF(Pubmed)
Abstract：
UNASSIGNED: Large cell neuroendocrine carcinoma (LCNEC) is a rare subtype of prostate cancer. The pathogenesis, clinical manifestation, treatment options, and prognosis are uncertain and underreported.
UNASSIGNED: A systematic search was conducted in April 2022 through PubMed, Embase, and Cochrane. We reviewed cases of LCNEC developed either from de novo or transformation from prostate adenocarcinoma and summarized the relevant pathophysiological course, treatment options, and outcomes.
UNASSIGNED: A total of 25 patients with a mean age of 70.4 (range 43 87 years old) from 18 studies were included in this review. 13 patients were diagnosed with de novo LCNEC of the prostate. 12 patients were from the transformation of adenocarcinoma post-hormonal therapy treatment. Upon initial diagnosis, patients diagnosed with de novo prostatic LCNEC had a mean serum PSA value of 24.6 ng/ml (range: 0.09-170 ng/ml, median 5.5 ng/ml), while transformation cases were significantly lower at 3.3 ng/ml (range: 0-9.3 ng/ml, median 0.05 ng/ml). The pattern of metastasis closely resembles prostate adenocarcinoma. Six out of twenty-three cases displayed brain metastasis matching the correlation between neuroendocrine tumors and brain metastasis. Three notable paraneoplastic syndromes included Cushings syndrome, dermatomyositis, and polycythemia. Most patients with advanced metastatic disease received conventional platinum-based chemotherapy with a mean survival of 5 months. There was one exception in the transformation cohort with a somatic BRCA2 mutation who was treated with a combination of M6620 and platinum-based chemotherapy with an impressive PFS of 20 months. Patients with pure LCNEC phenotype have worse survival outcomes when compared to those with mixed LCNEC and adenocarcinoma phenotypes. It is unclear whether there is a survival benefit to administering ADT in pure pathologies.
UNASSIGNED: LCNEC of the prostate is a rare disease that can occur de novo or transformation from prostatic adenocarcinoma. Most patients present at an advanced stage with poor prognosis and are treated with conventional chemotherapy regimens. Patients who had better outcomes were those who were diagnosed at an early stage and received treatment with surgery or radiation and androgen deprivation therapy (ADT). There was one case with an exceptional outcome that included a treatment regimen of M6620 and chemotherapy.
UNASSIGNED: A systematic search was conducted in April 2022 through PubMed, Embase, and Cochrane. We reviewed cases of LCNEC developed either from de novo or transformation from prostate adenocarcinoma and summarized the relevant pathophysiological course, treatment options, and outcomes.
UNASSIGNED: A total of 25 patients with a mean age of 70.4 (range 43 87 years old) from 18 studies were included in this review. 13 patients were diagnosed with de novo LCNEC of the prostate. 12 patients were from the transformation of adenocarcinoma post-hormonal therapy treatment. Upon initial diagnosis, patients diagnosed with de novo prostatic LCNEC had a mean serum PSA value of 24.6 ng/ml (range: 0.09-170 ng/ml, median 5.5 ng/ml), while transformation cases were significantly lower at 3.3 ng/ml (range: 0-9.3 ng/ml, median 0.05 ng/ml). The pattern of metastasis closely resembles prostate adenocarcinoma. Six out of twenty-three cases displayed brain metastasis matching the correlation between neuroendocrine tumors and brain metastasis. Three notable paraneoplastic syndromes included Cushings syndrome, dermatomyositis, and polycythemia. Most patients with advanced metastatic disease received conventional platinum-based chemotherapy with a mean survival of 5 months. There was one exception in the transformation cohort with a somatic BRCA2 mutation who was treated with a combination of M6620 and platinum-based chemotherapy with an impressive PFS of 20 months. Patients with pure LCNEC phenotype have worse survival outcomes when compared to those with mixed LCNEC and adenocarcinoma phenotypes. It is unclear whether there is a survival benefit to administering ADT in pure pathologies.
UNASSIGNED: LCNEC of the prostate is a rare disease that can occur de novo or transformation from prostatic adenocarcinoma. Most patients present at an advanced stage with poor prognosis and are treated with conventional chemotherapy regimens. Patients who had better outcomes were those who were diagnosed at an early stage and received treatment with surgery or radiation and androgen deprivation therapy (ADT). There was one case with an exceptional outcome that included a treatment regimen of M6620 and chemotherapy.
摘要：
■大细胞神经内分泌癌（LCNEC）是前列腺癌的一种罕见亚型。发病机制，临床表现,治疗方案,预后不确定且报告不足。
■2022年4月通过PubMed进行了系统搜索，Embase,还有Cochrane.我们回顾了LCNEC从头或从前列腺腺癌转变而发展的病例，并总结了相关的病理生理过程。治疗方案,和结果。
■本综述共纳入18项研究中的25例患者，平均年龄70.4岁（范围43～87岁）。13例患者被诊断为前列腺从头LCNEC。12例患者来自激素治疗后的腺癌转化。初步诊断后,诊断为从头前列腺LCNEC的患者的平均血清PSA值为24.6ng/ml（范围：0.09-170ng/ml，中位数5.5ng/ml），而转化病例在3.3ng/ml（范围：0-9.3ng/ml，中位数0.05ng/ml）。转移的模式与前列腺腺癌非常相似。23例中有6例显示脑转移，这与神经内分泌肿瘤和脑转移的相关性相匹配。三种值得注意的副肿瘤综合征包括库辛斯综合征，皮肌炎,和红细胞增多症。大多数晚期转移性疾病患者接受常规铂类化疗，平均生存期为5个月。在具有体细胞BRCA2突变的转化队列中，有一个例外，他接受了M6620和基于铂的化疗的组合治疗，PFS为20个月。与具有混合LCNEC和腺癌表型的患者相比,具有纯LCNEC表型的患者具有更差的生存结果。尚不清楚在纯病理中施用ADT是否有生存益处。
■前列腺的LCNEC是一种罕见的疾病，可以从头发生或从前列腺腺癌转变。大多数患者处于晚期，预后不良，并接受常规化疗方案治疗。结果较好的患者是早期诊断并接受手术或放射和雄激素剥夺疗法（ADT）治疗的患者。有一例具有异常结果的病例包括M6620治疗方案和化疗。
■2022年4月通过PubMed进行了系统搜索，Embase,还有Cochrane.我们回顾了LCNEC从头或从前列腺腺癌转变而发展的病例，并总结了相关的病理生理过程。治疗方案,和结果。
■本综述共纳入18项研究中的25例患者，平均年龄70.4岁（范围43～87岁）。13例患者被诊断为前列腺从头LCNEC。12例患者来自激素治疗后的腺癌转化。初步诊断后,诊断为从头前列腺LCNEC的患者的平均血清PSA值为24.6ng/ml（范围：0.09-170ng/ml，中位数5.5ng/ml），而转化病例在3.3ng/ml（范围：0-9.3ng/ml，中位数0.05ng/ml）。转移的模式与前列腺腺癌非常相似。23例中有6例显示脑转移，这与神经内分泌肿瘤和脑转移的相关性相匹配。三种值得注意的副肿瘤综合征包括库辛斯综合征，皮肌炎,和红细胞增多症。大多数晚期转移性疾病患者接受常规铂类化疗，平均生存期为5个月。在具有体细胞BRCA2突变的转化队列中，有一个例外，他接受了M6620和基于铂的化疗的组合治疗，PFS为20个月。与具有混合LCNEC和腺癌表型的患者相比,具有纯LCNEC表型的患者具有更差的生存结果。尚不清楚在纯病理中施用ADT是否有生存益处。
■前列腺的LCNEC是一种罕见的疾病，可以从头发生或从前列腺腺癌转变。大多数患者处于晚期，预后不良，并接受常规化疗方案治疗。结果较好的患者是早期诊断并接受手术或放射和雄激素剥夺疗法（ADT）治疗的患者。有一例具有异常结果的病例包括M6620治疗方案和化疗。
