Meta-analysis of randomized trials of prostate specific antigen progression and death rate in patients with locally advanced prostate cancer / 中华泌尿外科杂志

ABSTRACT

Objective To verify the best treatment strategy in reducing prostate specific antigen (PSA) progression and death rate in patients with locally advanced prostate cancer by a meta-analysis. Methods The literature search strategy was followed according to the Collaborative Review Group search strategy. Published data of randomized clinical trials comparing radical prostatectomy (RP) plus adjuvant therapy to either RP alone or other treatment were analyzed. Both fixed effect model and randomized effect model were applied and odds ratio (OR) with its 95% confidence interval (95% CI) was also used as the effect size 'estimate. Results Eight clinical trials were chosen with total in-volved cases of 3826. There were 5 trials compared post radical prostatectomy plus adjuvant hormonal therapy with radical prostatectomy alone. PSA progression was used as the indicator of progression and the combined OR was 0.86 (95%CI 0.48-1.56). There were 3 trails compared the combination of radical prostateetomy with hormonal therapy and radical prostatectomy alone. Disease specific death rate was used as the evaluating criteria and the OR was 0.72(95%CI,0.51-1.02). Conclusion RP plus adjuvant hormonal therapy can reduce PSA progression of patients with locally advanced pros-tate cancer, but it has no significant effect on disease specific death rate.