Impact of Prostate Size on the Outcomes of Radical Prostatectomy: A Systematic Review and Meta-Analysis
Background: The impact of prostate size on the radical prostatectomy outcome is not clear. Several published reports have shown conflicting results. Objectives: To investigate the effect of prostate size on the surgical, functional and oncological results of radical prostatectomy. Methods: A systema...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-12-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/23/6130 |
| _version_ | 1797507903919226880 |
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| author | Omar Fahmy Nabil A. Alhakamy Osama A. A. Ahmed Mohd Ghani Khairul-Asri |
| author_facet | Omar Fahmy Nabil A. Alhakamy Osama A. A. Ahmed Mohd Ghani Khairul-Asri |
| author_sort | Omar Fahmy |
| collection | DOAJ |
| description | Background: The impact of prostate size on the radical prostatectomy outcome is not clear. Several published reports have shown conflicting results. Objectives: To investigate the effect of prostate size on the surgical, functional and oncological results of radical prostatectomy. Methods: 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. Results: Eighteen studies including 12,242 patients were included. Estimated blood loss was significantly less with smaller prostates (Z = 3.01; <i>p</i> = 0.003). The complications rate was 17% with larger prostates, compared to 10% for smaller prostates (Z = 5.73; <i>p</i> < 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; <i>p</i> = 0.11). The rate of positive surgical margins was significantly higher with smaller prostates (20.2% vs. 17.8%). (Z = 2.52; <i>p</i> = 0.01). The incidence of biochemical recurrence was higher with smaller prostates (7.8% vs. 4.9%) (Z = 1.87; <i>p</i> = 0.06). Conclusion: 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. |
| first_indexed | 2024-03-10T04:55:04Z |
| format | Article |
| id | doaj.art-2d7e36f4f9c24ce79868cf6c9999d74a |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T04:55:04Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-2d7e36f4f9c24ce79868cf6c9999d74a2023-11-23T02:15:10ZengMDPI AGCancers2072-66942021-12-011323613010.3390/cancers13236130Impact of Prostate Size on the Outcomes of Radical Prostatectomy: A Systematic Review and Meta-AnalysisOmar Fahmy0Nabil A. Alhakamy1Osama A. A. Ahmed2Mohd Ghani Khairul-Asri3Department of Urology, Universiti Putra Malaysia (UPM), Serdang 43400, MalaysiaDepartment of Pharmaceutics & Industrial Pharmacy, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi ArabiaDepartment of Pharmaceutics & Industrial Pharmacy, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi ArabiaDepartment of Urology, Universiti Putra Malaysia (UPM), Serdang 43400, MalaysiaBackground: The impact of prostate size on the radical prostatectomy outcome is not clear. Several published reports have shown conflicting results. Objectives: To investigate the effect of prostate size on the surgical, functional and oncological results of radical prostatectomy. Methods: 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. Results: Eighteen studies including 12,242 patients were included. Estimated blood loss was significantly less with smaller prostates (Z = 3.01; <i>p</i> = 0.003). The complications rate was 17% with larger prostates, compared to 10% for smaller prostates (Z = 5.73; <i>p</i> < 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; <i>p</i> = 0.11). The rate of positive surgical margins was significantly higher with smaller prostates (20.2% vs. 17.8%). (Z = 2.52; <i>p</i> = 0.01). The incidence of biochemical recurrence was higher with smaller prostates (7.8% vs. 4.9%) (Z = 1.87; <i>p</i> = 0.06). Conclusion: 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.https://www.mdpi.com/2072-6694/13/23/6130prostate sizeprostate volumeprostate weightradical prostatectomyprostate cancer |
| spellingShingle | Omar Fahmy Nabil A. Alhakamy Osama A. A. Ahmed Mohd Ghani Khairul-Asri Impact of Prostate Size on the Outcomes of Radical Prostatectomy: A Systematic Review and Meta-Analysis Cancers prostate size prostate volume prostate weight radical prostatectomy prostate cancer |
| title | Impact of Prostate Size on the Outcomes of Radical Prostatectomy: A Systematic Review and Meta-Analysis |
| title_full | Impact of Prostate Size on the Outcomes of Radical Prostatectomy: A Systematic Review and Meta-Analysis |
| title_fullStr | Impact of Prostate Size on the Outcomes of Radical Prostatectomy: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Impact of Prostate Size on the Outcomes of Radical Prostatectomy: A Systematic Review and Meta-Analysis |
| title_short | Impact of Prostate Size on the Outcomes of Radical Prostatectomy: A Systematic Review and Meta-Analysis |
| title_sort | impact of prostate size on the outcomes of radical prostatectomy a systematic review and meta analysis |
| topic | prostate size prostate volume prostate weight radical prostatectomy prostate cancer |
| url | https://www.mdpi.com/2072-6694/13/23/6130 |
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