Is Tamsulosin 0.2 mg Effective and Safe as a First-Line Treatment Compared with Other Alpha Blockers?: A Meta-Analysis and a Moderator Focused Study

PURPOSE: Tamsulosin 0.2 mg is used widely in Asian people, but the low dose has been studied less than tamsulosin 0.4 mg or other alpha blockers of standard dose. This study investigated the efficacy and safety of tamsulosin 0.2 mg by a meta-analysis and meta-regression. MATERIALS AND METHODS: We conducted a meta-analysis of efficacy of tamsulosin 0.2 mg using International Prostate Symptom Score (IPSS), maximal urinary flow rate (Qmax), post-voided residual volume (PVR), and quality of life (QoL). Safety was analyzed using adverse events. Relevant studies were searched using MEDLINE, EMBASE, and Cochrane library from January 1980 to June 2013. RESULTS: Ten studies were included with a total sample size of 1418 subjects [722 tamsulosin 0.2 mg group and 696 other alpha-blockers (terazosin, doxazosin, naftopidil, silodosin) group]. Study duration ranged from 4 to 24 weeks. The pooled overall standardized mean differences (SMD) in the mean change of IPSS from baseline for the tamsulosin group versus the control group was 0.02 [95% confidence interval (CI); -0.20, 0.25]. The pooled overall SMD in the mean change of QoL from baseline for the tamsulosin group versus the control group was 0.16 (95% CI; -0.16, 0.48). The regression analysis with the continuous variables (number of patients, study duration) revealed no significance in all outcomes as IPSS, QoL, and Qmax. CONCLUSION: This study clarifies that tamsulosin 0.2 mg has similar efficacy and fewer adverse events compared with other alpha-blockers as an initial treatment strategy for men with lower urinary tract symptoms.

Significance of Expressions of bcl-2 and p53 Protein as the Prognostic Factor in Metastatic Prostate Adenocarcinoma / 대한비뇨기과학회지

PURPOSE: We investigated the significance of bcl-2 and p53 protein expressions as the prognostic factor in metastatic prostate adenocarcinoma. MATERIALS AND METHODS: Nineteen paraffin-embedded prostatic cancer tissues were examined using immunohistochemical staining for bcl-2 and p53 protein. We evaluated correlation of bcl-2 and p53 protein expressions with cancer progression free interval, pretreatment PSA and Gleason score. RESULTS: Seven out of 19 cases (36.9%) were positive for p53 and 3 cases (15.8%) were positive for bcl-2 protein. Mean disease progression free interval in positive patients for bcl-2 and p53 protein expressions was 8.7 months and 10.3 months, respectively. However, it was 18.3 months and 21 months in negative expressions, respectively. The difference of mean disease progression free interval between positive and negative groups for p53 protein expression was statistically significant (p<0.05) but not in bcl-2 protein groups. The rates of positive staining for bcl-2 and p53 protein were 0% (0/8) and 37.5% (3/8), respectively, in Geason score 5-7 groups, 27.3% (3/11) and 36.4% (4/11) in 8-10 groups. Neither of proteins had significant correlation with Gleason score and pretreatment PSA. CONCLUSIONS: The expression of p53 protein was correlated with significant short disease progression free interval but bcl-2 overexpression had relative short disease progression interval without statistical significance. These results suggest that expressions of bcl-2 and p53 have considerable prognostic impact and these gene products would provide useful information about prognosis of metastatic prostate adenocarcinoma.