Baladakis John, Perera Marlon, Bolton Damien, Lawrentschuk Nathan, Adam Ahmed
Department of Urology, Helen Joseph Hospital, University of the Witwatersrand, Johannesburg, South Africa.
Department of Pediatric Urology, Rahima Moosa Mother & Child (Coronation) Hospital, University of the Witwatersrand, Johannesburg, South Africa.
Curr Urol. 2019 Jul;12(4):169-176. doi: 10.1159/000499309. Epub 2019 Jul 20.
We aimed to compare the outcome of curative treatment options in localised Prostate Cancer (PCa) amongst HIV positive (HIV+) men.
A systematic search of the Cochrane Library of Systematic Reviews, the Scopus and PubMed databases was performed (January 1995 to November 2015) using pre-determined search terms. Outcome measures for comparison included the rate of biochemical failure (BCF), survival benefit and complications.
A total of 14 eligible articles were identified for inclusion, representing a total of 202 HIV+ men with PCa. Radical Prostatectomy was performed in 40/153 compared to 109/153 patients undergoing alternative (non-surgical) treatments options. Only 3 studies compared outcomes within their respective study cohort. One study (n = 10) reported BCF results with 1/2 BCF patient in the surgical arm vs. 1/8 BCF positive patients in the non-surgical arm (mean 46 months follow-up), while two other studies reported no occurrences of BCF within both arms of their studies.
Due to paucity in the literature, there is insufficient evidence to support a certain treatment modality arm specifically for HIV+ men with localized PCa. An individualized management algorithm seems feasible within this cohort, until more definitive studies are performed.
我们旨在比较针对HIV阳性（HIV+）男性局限性前列腺癌（PCa）的根治性治疗方案的结果。
使用预先确定的检索词，对Cochrane系统评价图书馆、Scopus和PubMed数据库进行了系统检索（1995年1月至2015年11月）。用于比较的结果指标包括生化失败（BCF）率、生存获益和并发症。
共确定了14篇符合纳入标准的文章，代表了总共202例患有PCa的HIV+男性。153例患者中40例接受了根治性前列腺切除术，而153例患者中109例接受了替代（非手术）治疗方案。只有3项研究在各自的研究队列中比较了结果。一项研究（n = 10）报告了BCF结果，手术组有1/2例BCF患者，非手术组有1/8例BCF阳性患者（平均随访46个月），而另外两项研究报告其研究的两组均未发生BCF。
由于文献资料匮乏，没有足够的证据支持专门针对患有局限性PCa的HIV+男性的某种治疗方式。在进行更多确定性研究之前，在此队列中采用个体化管理算法似乎是可行的。
