Impact of local treatment on overall survival of patients with metastatic prostate cancer: systematic review and meta-analysis

被引:1
作者
Carneiro, Arie [1 ,2 ]
Baccaglini, Willy [2 ]
Glina, Felipe P. A. [3 ]
Kayano, Paulo P. [1 ]
Nunes, Victor M. [4 ]
Smaletz, Oren [5 ]
Bernardo, Wanderley Marques [4 ]
de Carvalho, Icaro Thiago [6 ]
Lemos, Gustavo Caserta [1 ]
机构
[1] Hosp Israelita Albert Einstein, Dept Urol, Sao Paulo, SP, Brazil
[2] ABC, Fac Med, Dept Urol, Sao Paulo, SP, Brazil
[3] Univ Metropolitana Santos, Fac Ciencias Med, Santos, SP, Brazil
[4] Ctr Univ Lusiada, Fac Ciencias Med Santos, Santos, SP, Brazil
[5] Hosp Israelita Albert Einstein, Dept Oncol, Sao Paulo, Brazil
[6] Hosp Israelita Albert Einstein, Dept Radioterapia, Sao Paulo, Brazil
来源
INTERNATIONAL BRAZ J UROL | 2017年 / 43卷 / 04期
关键词
Prostate; Survival; Radiation Oncology; Prostatic Neoplasms; RADICAL PROSTATECTOMY; PRIMARY TUMOR; CYTOREDUCTIVE SURGERY; ANDROGEN DEPRIVATION; MEN; THERAPY; RADIOTHERAPY; CARCINOMA; RISK; CARE;
D O I
10.1590/S1677-5538.IBJU.2016.0483
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Context: Currently, standard treatment of metastatic prostatic cancer (MPCa) is androgen- deprivation therapy (ADT). Recent studies suggested that local treatment of MPCa is related to increase of survival of those patients, as observed in other tumors. Objective: To evaluate the impact of local treatment on overall survival and cancer specific survival in 3 and 5 years in patients with MPCa. Materials and Methods: Systematic review and meta-analysis of population studies published at PubMed, Scielo, Lilacs, Cochrane and EMBASE databases until June 2016. Several large cohorts and Post-Roc studies were included, that evaluated patients with MPCa submitted to local treatment (LT) using radiotherapy (RDT), surgery (RP) or brachytherapy (BCT) or not submitted to local treatment (NLT). Results: 34.338 patients were analyzed in six included papers, 31.653 submitted to NLT and 2.685 to LT. Overall survival in three years was significantly higher in patients submitted to LT versus NLT (64.2% vs. 44.5%; RD 0.19, 95% CI, 0.17-0.21; p < 0.00001; I-2 = 0%), as well as in five years (51.9% vs. 23.6%; RD 0.30, 95% CI, 0.11-0.49; p < 0.00001; I-2 = 97%). Sensitive analysis according to type of local treatment showed that surgery (78.2% and 45.0%; RD 0.31, 95% CI, 0.26-0.35; p < 0.00001; I-2= 50%) and radiotherapy (60.4% and 44.5%; RD 0.17, 95% CI, 0.12-0.22; p < 0.00001; I-2= 67%) presented better outcomes. Conclusion: LT using RDT, RP or BCT seems to significantly improve overall survival and cancer-specific survival of patients with metastatic prostatic cancer. Prospective and randomized studies must be performed in order to confirm our results.
引用
收藏
页码:588 / 599
页数:12
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