Local treatment for the prognosis of hormone-sensitive metastatic prostate cancer: a Meta-analysis / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the effect of local treatment for the prognosis of hormonesensitive metastatic prostate cancer.Methods A systematic review of the literature about local treatment for the prognosis of hormone-sensitive metastatic prostate cancer was performed,searching Medline,Embase,Cochrane Library,CBM,CNKI,VIP and Wan Fang database from January 2001 to October 2016.Two authors reviewed the records to identify comparative studies.A meta-analysis was conducted using Review Manager 5.0.Results Five studies were enrolled,including 29 354 patients.Meta-analysis showed that,compared with no local treatment,local treatment had a significant beneficial effect in 5-year overall survival rate (OR =0.18,95 ％ CI 0.15-0.22,P ＜ 0.01),5-year disease specific survival rate (OR =0.39,95 ％ CI 0.31-0.49,P＜0.01) as well as 3-year overall survival rate (OR =0.47,95％ CI 0.35-0.62,P＜0.01).Sub-group analysis showed that,compared with no local treatment,prostatectomy had a significant beneficial effect in 5-year overall survival rate (OR =0.17,95 ％ CI 0.12-0.25,P ＜ 0.01),5-year disease specific survival rate (OR =0.30,95％ CI 0.22-0.40,P ＜0.01) as well as 3-year overall survival rate (OR=0.25,95％CI 0.19-0.32,P ＜0.01),and external beam radiation therapy only had a significant beneficial effect in 3-year overall survival rate (OR =0.54,95％ CI 0.42-0.69,P ＜ 0.01).Conclusions Prostatectomy and external beam radiation therapy may have a survival benefit for hormone-sensitive metastatic prostate cancer.Prospective randomized controlled studies are necessary because of the limits of current studies.