Fahmy Omar, Alhakamy Nabil A, Ahmed Osama A A, Khairul-Asri Mohd Ghani
Department of Urology, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia.
Department of Pharmaceutics & Industrial Pharmacy, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
Cancers (Basel). 2021 Dec 5;13(23):6130. doi: 10.3390/cancers13236130.
The impact of prostate size on the radical prostatectomy outcome is not clear. Several published reports have shown conflicting results.
To investigate the effect of prostate size on the surgical, functional and oncological results of radical prostatectomy.
A systematic review and meta-analysis were carried out in accordance with the PRISMA criteria. Finally, we investigated the research that reported on the impact of prostate size on radical prostatectomy outcome. The Review Manager (RevMan) software version 5.4 was utilized for statistical analysis.
Eighteen studies including 12,242 patients were included. Estimated blood loss was significantly less with smaller prostates (Z = 3.01; = 0.003). The complications rate was 17% with larger prostates, compared to 10% for smaller prostates (Z = 5.73; < 0.00001). Seventy-three percent of patients with a smaller prostate were continent within one month, compared to 64% with a larger prostate (Z = 1.59; = 0.11). The rate of positive surgical margins was significantly higher with smaller prostates (20.2% vs. 17.8%). (Z = 2.52; = 0.01). The incidence of biochemical recurrence was higher with smaller prostates (7.8% vs. 4.9%) (Z = 1.87; = 0.06).
Larger prostate size is associated with more blood loss and a higher rate of complications. However, the oncological outcome is better, compared to that in patients with smaller prostates. The impact of the size on the functional outcome is not clear.
前列腺大小对根治性前列腺切除术结果的影响尚不清楚。一些已发表的报告显示了相互矛盾的结果。
研究前列腺大小对根治性前列腺切除术的手术、功能和肿瘤学结果的影响。
按照PRISMA标准进行系统评价和荟萃分析。最后，我们调查了报告前列腺大小对根治性前列腺切除术结果影响的研究。使用Review Manager（RevMan）5.4版软件进行统计分析。
纳入18项研究，共12242例患者。前列腺较小者估计失血量明显较少（Z = 3.01；P = 0.003）。前列腺较大者并发症发生率为17%，而前列腺较小者为10%（Z = 5.73；P < 0.00001）。前列腺较小的患者中有73%在1个月内实现控尿，而前列腺较大的患者为64%（Z = 1.59；P = 0.11）。前列腺较小者手术切缘阳性率明显更高（20.2%对17.8%）（Z = 2.52；P = 0.01）。前列腺较小者生化复发发生率更高（7.8%对4.9%）（Z = 1.87；P = 0.06）。
前列腺体积较大与更多的失血量和更高的并发症发生率相关。然而，与前列腺较小的患者相比，其肿瘤学结果更好。前列腺大小对功能结果的影响尚不清楚。
