Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Department of Emergency, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
J Robot Surg. 2024 Oct 14;18(1):367. doi: 10.1007/s11701-024-02123-1.
This research aims to use a data-driven analytical method to compare the effectiveness of High-Intensity Focused Ultrasound (HIFU) partial gland ablation with Robot-Assisted Radical Prostatectomy (RARP) for treating localized prostate cancer, evaluating variations in treatment results.
We performed a systematic review of the literature, covering key databases including the Cochrane Library, PubMed, EMBASE, Web of Science, and Google Scholar, with the latest information updated until August 2024. We utilized Stata 18 for data analysis, computing weighted mean differences (WMDs) for continuous data and odds ratios (ORs) for categorical data, with all results reported alongside 95% confidence intervals (CIs). Additionally, the studies included were evaluated using the Newcastle-Ottawa Scale (NOS).
This meta-analysis incorporated data from three paired studies, encompassing a total of 1,503 patients. Patients treated with HIFU experienced a shorter hospital stay (WMD = -2.78, 95%CI -5.14,-0.43; p = 0.02) compared to those who received RARP. Additionally, evaluations at 3 and 12 months post-surgery revealed that the HIFU group exhibited better recovery in urinary continence and sexual function than the RARP group. However, there were no notable disparities in complication rates (OR = 1.48, 95%CI 0.92,2.40; p = 0.110) and the requirement for salvage therapy (OR = 2.92, 95%CI 0.60,14.33; p = 0.186) between the two treatment methods.
In conclusion, this meta-analysis appears to suggest potential benefits of HIFU partial gland ablation in possibly reducing the length of hospital stays and seems to indicate that it might be associated with improved recovery in terms of urinary incontinence and sexual function, particularly during the early to mid-term postoperative period. Although the differences in complication rates and the requirement for salvage therapy between the two surgical methods were not statistically significant, the findings provided by this analysis are instrumental in guiding clinical decision-making.
本研究旨在采用数据驱动的分析方法比较高强度聚焦超声（HIFU）部分腺体消融与机器人辅助前列腺根治术（RARP）治疗局限性前列腺癌的疗效，评估治疗效果的差异。
我们对文献进行了系统综述，涵盖了 Cochrane 图书馆、PubMed、EMBASE、Web of Science 和 Google Scholar 等主要数据库，最新信息更新至 2024 年 8 月。我们使用 Stata 18 进行数据分析，计算连续数据的加权均数差（WMD）和分类数据的比值比（OR），所有结果均报告 95%置信区间（CI）。此外，还使用纽卡斯尔-渥太华量表（NOS）对纳入的研究进行评估。
这项荟萃分析纳入了三项配对研究的数据，共纳入了 1503 名患者。与接受 RARP 治疗的患者相比，接受 HIFU 治疗的患者住院时间更短（WMD=-2.78，95%CI-5.14，-0.43；p=0.02）。此外，术后 3 个月和 12 个月的评估结果显示，HIFU 组在尿控和性功能恢复方面优于 RARP 组。然而，两种治疗方法在并发症发生率（OR=1.48，95%CI 0.92，2.40；p=0.110）和挽救性治疗需求（OR=2.92，95%CI 0.60，14.33；p=0.186）方面没有显著差异。
综上所述，这项荟萃分析似乎表明 HIFU 部分腺体消融在可能缩短住院时间方面具有潜在优势，并且似乎表明其可能与早期至中期术后尿失禁和性功能恢复的改善相关。尽管两种手术方法的并发症发生率和挽救性治疗需求之间的差异没有统计学意义，但本分析提供的结果有助于指导临床决策。
