Hu Xiheng, Huang Jianghai, Wen Sailan, Fu Jun, Chen Minfeng
Department of Urology, Xiangya Hsopital, Central South University, Changsha, Hunan Province 410008, China.
Department of Pathology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province 410011, China.
Oncotarget. 2017 Jun 28;8(59):100469-100477. doi: 10.18632/oncotarget.18761. eCollection 2017 Nov 21.
We conducted a meta-analysis to compare the efficacy of brachytherapy and penectomy in patients with penile cancer. We searched the published articles in the PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang databases up to March 20, 2017. Twenty-two studies entered the final analyses. We used five-year overall survival rate, five-year local control rate, disease-free progression and lymph node positive rate to assess the efficacy. The meta-analysis found that patients who received penectomy had higher five-year local control rate (85% vs 80%, odds ratio = 0.72, 95% confidence interval: 0.58-0.90), five-year disease-free progression rate (77% vs 72%, odds ratio = 0.77, 95% confidence interval: 0.63-0.93) and lymph node positive rates (24% vs 20%, odds ratio = 0.79, 95% confidence interval: 0.64-0.98) than brachytherapy. No significant difference was observed for two group in five-year overall survival rate (76% vs 74%, odds ratios = 1.11 with the 95% confidence interval: 0.91-1.36). Both of penectomy and brachytherapy can improve the survival status. Penectomy provided better control efficacy, and not improved the survival status compared with brachytherapy solely. However, further research was required because of retrospective nature and potential bias of the data.
我们进行了一项荟萃分析,以比较近距离放射疗法和阴茎切除术对阴茎癌患者的疗效。我们检索了截至2017年3月20日发表在PubMed、科学网、中国知网和万方数据库中的文章。22项研究纳入最终分析。我们使用五年总生存率、五年局部控制率、无病进展率和淋巴结阳性率来评估疗效。荟萃分析发现,接受阴茎切除术的患者五年局部控制率(85%对80%,优势比=0.72,95%置信区间:0.58-0.90)、五年无病进展率(77%对72%,优势比=0.77,95%置信区间:0.63-0.93)和淋巴结阳性率(24%对20%,优势比=0.79,95%置信区间:0.64-0.98)均高于近距离放射疗法。两组五年总生存率无显著差异(76%对74%,优势比=1.11,95%置信区间:0.91-1.36)。阴茎切除术和近距离放射疗法均可改善生存状况。阴茎切除术提供了更好的控制效果,但与单纯近距离放射疗法相比,并未改善生存状况。然而,由于数据的回顾性性质和潜在偏倚,仍需要进一步研究。