Department of Urology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.
Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Int J Urol. 2024 Nov;31(11):1223-1233. doi: 10.1111/iju.15540. Epub 2024 Jul 16.
This study aims to evaluate the efficacy of local treatment (LT), including radiotherapy (RT) and cytoreductive prostatectomy (CRP), in improving outcomes for patients with oligometastatic prostate cancer (OmPCa).
A systematic review and meta-analysis of articles from PubMed, Embase, and Web of Science published between 2010 and November 2023 were conducted. The study included 11 articles, comprising three randomized controlled trials (RCTs) and eight retrospective analyses. The study assessed overall survival (OS), radiographic progression-free survival (rPFS), prostate-specific antigen (PSA) PFS, cancer-specific survival (CSS), and complication rate (CR).
OS was significantly improved in the LT group, with both RCTs and non-RCTs showing statistical significance [hazard ratios (HR) = 0.64; 95% confidence intervals (95% CIs), 0.51-0.80; p < 0.0001; HR = 0.55; 95% CIs, 0.40-0.77; p = 0.0004]. For rPFS, RCTs did not show statistically significant outcomes (HR = 0.60; 95% CIs, 0.34-1.07; p = 0.09), whereas non-RCTs demonstrated significant results (HR = 0.42; 95% CIs, 0.24-0.72; p = 0.002). Both RCTs and non-RCTs showed a significant improvement in PSA-PFS (HR = 0.44; 95%CI, 0.29-0.67; p = 0.0001; HR = 0.51; 95% CIs, 0.32-0.81; p = 0.004). For CSS, RCTs demonstrated statistical differences (HR = 0.65; 95% CIs, 0.47-0.90; p = 0.009), whereas non-RCTs did not (HR = 0.61; 95% CIs, 0.29-1.27; p = 0.19). Regarding CR, the risk difference was -0.22 (95% CIs, -0.32 to -0.12; p < 0.00001).
LT significantly improved OS and PFS in patients with OmPCa. Further RCTs are necessary to confirm these results.
本研究旨在评估局部治疗（LT），包括放疗（RT）和去势前列腺切除术（CRP），在改善寡转移前列腺癌（OmPCa）患者结局方面的疗效。
对 2010 年至 2023 年 11 月期间在 PubMed、Embase 和 Web of Science 上发表的文章进行了系统的综述和荟萃分析。研究纳入了 11 项研究，包括 3 项随机对照试验（RCT）和 8 项回顾性分析。研究评估了总生存（OS）、影像学无进展生存（rPFS）、前列腺特异性抗原（PSA）无进展生存（PSA-PFS）、癌症特异性生存（CSS）和并发症发生率（CR）。
LT 组的 OS 显著改善，RCT 和非 RCT 均显示出统计学意义[风险比（HR）=0.64；95%置信区间（95%CI），0.51-0.80；p<0.0001；HR=0.55；95%CI，0.40-0.77；p=0.0004]。对于 rPFS，RCT 未显示出统计学显著的结果（HR=0.60；95%CI，0.34-1.07；p=0.09），而非 RCT 则显示出显著的结果（HR=0.42；95%CI，0.24-0.72；p=0.002）。RCT 和非 RCT 均显示 PSA-PFS 有显著改善（HR=0.44；95%CI，0.29-0.67；p=0.0001；HR=0.51；95%CI，0.32-0.81；p=0.004）。对于 CSS，RCT 显示出统计学差异（HR=0.65；95%CI，0.47-0.90；p=0.009），而非 RCT 则没有（HR=0.61；95%CI，0.29-1.27；p=0.19）。关于 CR，风险差异为-0.22（95%CI，-0.32 至-0.12；p<0.00001）。
LT 显著改善了 OmPCa 患者的 OS 和 PFS。需要进一步的 RCT 来证实这些结果。
