Department of Urology, Royal Hospital, Muscat, Oman.
Urologia. 2022 Feb;89(1):16-30. doi: 10.1177/03915603211036631. Epub 2021 Aug 6.
Cytoreductive prostatectomy had gained a lot of interest in treatment of metastatic prostate cancer (mPCa) but this treatment approach is still in the experimental phase. This systematic review and meta-analysis was conducted to shed light on the merits of cytoreductive radical prostatectomy compared to systemic and radiation therapy in treatment of mPCa. In February 2021, summary data from 12 original research papers covering 100,973 patients is abstracted. PubMed/Medline, Scopus, Google Scholar, EMBASE, and the Cochrane Library were all reviewed and 12 publications were chosen for inclusion. The evaluated outcomes were 1-, 3-, and 5-year Cancer-Specific (CSS) and overall survival (OS) rates. Cytoreductive radical prostatectomy had significantly higher survival rate for 1-year (OR: 3.03; 95% CI: 2.30-3.98; < 0.001), 3-year (OR: 2.47; 95% CI: 2.14-3.51; < 0.001), and 5-year CSS rates (OR: 2.90; 95% CI: 2.10-4.01; < 0.001) than systemic therapy in mPCa. Higher significant rates of 1-year (OR: 2.35; 95% CI: 1.65-3.36; < 0.001), three-year (OR: 2.25; 95% CI: 1.96-2.60; < 0.001), and 5-year OS rates (OR: 2.54; 95% CI: 2.10-3.08; < 0.001) were also detected for cytoreductive radical prostatectomy compared to systemic therapy. There were no significant differences in 1-year (OR: 1.21; 95% CI: 0.88-1.66; = 0.25), 3-year (OR: 1.21; 95% CI: 0.92-1.59; = 0.18), and 5-year CSS rates (OR: 0.91; 95% CI: 0.58-1.42; = 0.67) between cytoreductive radical prostatectomy and radiation in mPCa patients. Also, no significant differences in 1-year (OR: 1.06; 95% CI: 0.77-1.47; = 0.71), 3-year (OR: 0.83; 95% CI: 0.60-1.14; = 0.25), and 5-year OS rates (OR: 1.84; 95% CI: 0.76-4.45; = 0.18) were detected between cytoreductive radical prostatectomy and radiation therapy. Cytoreductive radical prostatectomy had significantly higher 1-, 3-, and 5-year CSS and OS rates compared to systemic therapy. Comparable CSS and OS rates were found between cytoreductive radical prostatectomy and radiation therapy.
去势前列腺切除术在转移性前列腺癌（mPCa）的治疗中引起了广泛关注，但这种治疗方法仍处于实验阶段。本系统评价和荟萃分析旨在阐明与全身治疗和放射治疗相比，去势根治性前列腺切除术在 mPCa 治疗中的优势。2021 年 2 月，从涵盖 100973 名患者的 12 篇原始研究论文中提取汇总数据。对 PubMed/Medline、Scopus、Google Scholar、EMBASE 和 Cochrane Library 进行了综述，共纳入 12 篇文献。评估的结局是 1、3 和 5 年的癌症特异性（CSS）和总生存率（OS）。去势根治性前列腺切除术在 1 年（OR：3.03；95%CI：2.30-3.98；<0.001）、3 年（OR：2.47；95%CI：2.14-3.51；<0.001）和 5 年 CSS 率（OR：2.90；95%CI：2.10-4.01；<0.001）方面具有更高的生存率，明显优于全身治疗。1 年（OR：2.35；95%CI：1.65-3.36；<0.001）、3 年（OR：2.25；95%CI：1.96-2.60；<0.001）和 5 年 OS 率（OR：2.54；95%CI：2.10-3.08；<0.001）也明显更高。去势根治性前列腺切除术与全身治疗相比，1 年（OR：1.21；95%CI：0.88-1.66；=0.25）、3 年（OR：1.21；95%CI：0.92-1.59；=0.18）和 5 年 CSS 率（OR：0.91；95%CI：0.58-1.42；=0.67）无显著差异。去势根治性前列腺切除术与放射治疗在 mPCa 患者中 1 年（OR：1.06；95%CI：0.77-1.47；=0.71）、3 年（OR：0.83；95%CI：0.60-1.14；=0.25）和 5 年 OS 率（OR：1.84；95%CI：0.76-4.45；=0.18）无显著差异。去势根治性前列腺切除术的 1、3 和 5 年 CSS 和 OS 率明显高于全身治疗。去势根治性前列腺切除术与放射治疗的 CSS 和 OS 率相当。
