Clinical features, treatment, prognosis, and outcome of 47 patients with pure squamous cell carcinoma of the prostate.

Abstract

7 Background: Pure squamous cell carcinoma of the prostate is a rare entity. Data regarding clinical features, management, and treatment outcomes are limited. As such, management of this cancer has been variable throughout the reported literature, and with limited success. Methods: A systematic review of the literature and secondary data analysis was performed to characterize clinical features, management, and survival outcomes. Results: In total, 47 cases of histologically-confirmed pure squamous cell carcinoma of the prostate were included in analysis. Pure squamous cell carcinoma of the prostate is a disease of older males with mean age at diagnosis of 68.5 years (range 42-85). Urinary obstruction was reported as a presenting symptom in 60% of cases. PSA was usually normal with a mean value of 1.6 (n = 11). The disease was metastatic at diagnosis in 32% of patients among cases that stage was reported (n = 31). The most common sites ( > 30%) of distant metastases are bone and lymph nodes. Metastasis to lung, liver, and brain were 20%, 7%, and 7%, respectively. In terms of management, chemotherapy was given in 28% of cases, radiation in 30%, and prostatectomy in 25.5%. Hormone therapy was rarely attempted (4%). Metastatic disease was associated with a significant decrease in survival when compared to localized disease, p = 0.006. Surgical management was associated with significantly increased survival, p = 0.041. Overall 1-year survival was 32%, while 3-year survival was 9%. Conclusions: Squamous cell carcinoma of the prostate has an aggressive clinical course and is associated with poor prognosis. There is urgent need for early detection and the development of novel treatment options.[Table: see text]

Genetic manipulation of LKB1 elicits lethal metastatic prostate cancer

“…The vast majority of available PCa high-throughput molecular studies focus on adenocarcinoma lesions, since this histological cancer type is predominant. However, according to PCa guidelines, squamous cell carcinoma of prostate presents an incidence of 0.5–1% and exhibits highly aggressive characteristics (Brunnhoelzl and Wang, 2018; Munoz et al, 2007). We searched for LKB1 -deficient PCa specimens that exhibited squamous pathological features.…”

“…Squamous cell carcinoma is included in the clinical guidelines as a highly aggressive subtype of PCa, with an incidence of 0.5–1% and average survival of 14 mo after diagnosis (Brunnhoelzl and Wang, 2018; Munoz et al, 2007). The combination of Pten and Lkb1 deletion in the prostate epithelium performed in this study results in aggressive squamous cell prostate carcinoma.…”

Metastatic squamous cell carcinoma transformed from prostatic adenocarcinoma following androgen deprivation therapy: A case report with clinicopathologic and molecular findings

“…Both cases of de novo SCC as well as SCC transformed from prostatic adenocarcinoma following androgen deprivation therapy (ADT) or radiotherapy have been reported. [1][2][3][4][5][6][7][8][9] Due to the rarity of prostatic SCC, the origin and mechanism of squamous differentiation remains uncertain, although SCC of the prostate is known to behave aggressively and does not typically respond to standard treatments used for conventional prostatic adenocarcinoma. [1][2][3][4][5][6][7][8][9] Confirming the primary site of metastatic SCC often requires correlation with clinical and imaging findings, as the morphologic and immunohistochemical features of SCC are not organ-specific.…”

“…[1][2][3][4][5][6][7][8][9] Due to the rarity of prostatic SCC, the origin and mechanism of squamous differentiation remains uncertain, although SCC of the prostate is known to behave aggressively and does not typically respond to standard treatments used for conventional prostatic adenocarcinoma. [1][2][3][4][5][6][7][8][9] Confirming the primary site of metastatic SCC often requires correlation with clinical and imaging findings, as the morphologic and immunohistochemical features of SCC are not organ-specific. 1,5,6,[10][11][12] In some cases, comprehensive genomic profiling (CGP) may provide additional information that can help confirm the primary site in addition to its utility in identifying potential targeted therapy options.…”

Competence against insufficiency: Why are men mostly safe from a rare and deadly prostate cancer?

“…However, once diagnosed with this form of PC, there is a significant decrease in survival compared to epithelial PC, and only very few therapeutic options are available. scPC has a 32% chance of metastasis (Brunnhoelzl and Wang, 2018), which is five times that of adenocarcinoma. Furthermore, androgen deprivation therapy (ADT) shows little efficacy.…”