Population-based analysis of treatment modalities and survival for clinically localized small-cell XXXX .

@entity1 @entity263 @entity5 @entity16178 @entity342
BACKGROUND: Small-cell @entity263 is an aggressive @entity5 whose rarity has prevented the development of a consensus management approach. The objective of the current study was to determine the treatment patterns and evaluate factors affecting overall survival for @entity1 with localized small-cell @entity263 . METHODS: After querying the National @entity5 Database, we identified all @entity1 diagnosed with localized small-cell @entity263 between 1998 and 2011 (n=287). Using Kaplan-Meier curves and Cox regression analyses, we assessed the effect of treatment and clinical stage on overall survival. RESULTS: Treatments included radiation therapy in 46% (n=131), chemotherapy in 38% (n=107), @entity342 deprivation therapy (ADT) in 22% (n=63) and radical prostatectomy in 13% (n=38). Median overall survival was 14.8 months. Upon multivariate analysis, local therapy (radical prostatectomy or radiation therapy) was associated with improved survival (hazard ratio (HR) 0.23, 95% confidence interval (CI) 0.14-0.38, P<0.001). Advanced clinical stage predicted worse survival among all @entity1 ( @entity16178 : HR 2.83, 95% CI 1.27-6.32, P=0.011; cT4: HR 3.26, 95% CI 1.50-7.07, P=0.003) and @entity1 who received local therapy ( @entity16178 : HR 4.67, 95% CI 1.41-15.44, P=0.012; cT4: HR 4.01, 95% CI 1.14-14.08, P=0.03) but not among @entity1 who received no local therapy ( @entity16178 : HR 1.64, 95% CI 0.51-5.27, P=0.4; cT4: HR 2.35, 95% CI 0.74-7.48, P=0.15). Age, receipt of chemotherapy and ADT, and clinical stage T2 disease (compared with T1) did not predict survival. CONCLUSION: @entity1 with localized small-cell @entity263 have a poor overall survival. Local therapy may represent a suitable and underused modality for select @entity1 .
