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Meta-Analysis
. 2015 Jan 12:5:7713.
doi: 10.1038/srep07713.

Systematic review and meta-analysis of the survival outcomes of first-line treatment options in high-risk prostate cancer

Jun H Lei  1 , Liang R Liu  1 , Qiang Wei  1 , Shi B Yan  2 , Tu R Song  1 , Fu S Lin  1 , Lu Yang  1 , De H Cao  1 , Hai C Yuan  1 , Wen B Xue  1 , Xiao Lv  1 , Ying C Cai  1 , Hao Zeng  1 , Ping Han  1
Affiliations
Meta-Analysis

Systematic review and meta-analysis of the survival outcomes of first-line treatment options in high-risk prostate cancer

Jun H Lei et al. Sci Rep. .

Abstract

Prostate cancer (PCa) is the most common non-dermatologic cancer in the western countries in western countries. High-risk PCa accounts for 15% of the diagnosed cases. In this study, we compare the long-term survival outcomes of radical prostatectomy (RP), radiation therapy (RT), brachytherapy (BT), androgen- deprivation therapy (ADT), and watchful waiting (WW) in high-risk prostate cancer (PCa). Overall, RP/(RT plus ADT) gave the best survival outcome in patients with high-risk PCa, whereas ADT/WW had the worst outcome. The overall priority for treatment strategy could be ranked as follows: RP/(RT plus ADT), RT, and ADT/WW. RP had significant better overall survival (OS) than RT or BT, and RP had significant lower cancer-specific mortality (CSM) than RT (0.51 [95% CI 0.30-0.73], P<0.001). ADT improved the cancer-specific survival (CSS) of RP based on a case-controlled study; added ADT to RT failed to challenge the position of RP but could improve the outcome of RT. In conclusions,RP/(RT plus adjuvant ADT) could both be used for the first-line therapy of high-risk PCa. When encountering an individual patient, urologists should consider various factors like tumors themselves, preferences of individuals, and so on.

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Conflict of interest statement

The authors declare no competing financial interests.

Figures

Figure 1
Figure 1. Flowchart of literature searches.
Figure 2
Figure 2. Forest plot of pooled hazard ratio (HR) for cancer-specific mortality (CSM).
See this image and copyright information in PMC

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