Cytoreductive prostatectomy may improve oncological outcomes in patients with oligometastatic prostate cancer: An updated systematic review and meta-analysis
The oncologic outcomes of cytoreductive prostatectomy (CRP) in oligometastatic prostate cancer (OmPCa) are still controversial. Therefore, we conducted a systematic review and meta-analysis on the oncologic outcome of CRP in OmPCa. OVID-Medline, OVID-Embase, and Cochrane Library databases were searc...
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| Format: | Article |
| Language: | English |
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Korean Urological Association
2023-05-01
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| Series: | Investigative and Clinical Urology |
| Subjects: | |
| Online Access: | https://www.icurology.org/pdf/10.4111/icu.20230058 |
| _version_ | 1827950667627495424 |
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| author | Doo Yong Chung Dong Hyuk Kang Hae Do Jung Joo Yong Lee Do Kyung Kim Jee Soo Ha Jinhyung Jeon Kang Su Cho |
| author_facet | Doo Yong Chung Dong Hyuk Kang Hae Do Jung Joo Yong Lee Do Kyung Kim Jee Soo Ha Jinhyung Jeon Kang Su Cho |
| author_sort | Doo Yong Chung |
| collection | DOAJ |
| description | The oncologic outcomes of cytoreductive prostatectomy (CRP) in oligometastatic prostate cancer (OmPCa) are still controversial. Therefore, we conducted a systematic review and meta-analysis on the oncologic outcome of CRP in OmPCa. OVID-Medline, OVID-Embase, and Cochrane Library databases were searched to identify eligible studies published before January 2023. A total of 11 studies (929 patients), 1 randomized controlled trial (RCT) and 10 non-RCT studies, were included in the final analysis. RCT and non-RCT were further analyzed separately. End points were progression-free-survival (PFS), time to castration-resistant prostate cancer (CRPCa), cancer-specific-survival (CSS) and overall-survival (OS). It was analyzed using hazard ratio (HR) and 95% confidence intervals (CIs). In PFS, in RCT, HR=0.43 (CIs=0.27–0.69) was shown statistically significant, but in non-RCTs, HR=0.50 (CIs=0.20–1.25), there was no statistical difference. And, in time to CRPCa was statistically significant in the CRP group in all analyses (RCT; HR=0.44; CIs=0.29–0.67) (non-RCTs; HR=0.64; CIs=0.47–0.88). Next, CSS was not statistically different between the two groups (HR=0.63; CIs=0.37–1.05). Finally, OS showed better results in the CRP group in all analyses (RCT; HR=0.44; CIs=0.26–0.76) (non-RCTs; HR=0.59; CIs=0.37–0.93). Patients who received CRP in OmPCa showed better oncologic outcomes compared to controls. Notably, time to CRPC and OS showed significantly improved compared with control. We recommend that experienced urologists who are capable of managing complications consider CRP as a strategy to achieve good oncological outcomes in OmPCa. However, since most of the included studies are non-RCT studies, caution should be exercised in interpreting the results. |
| first_indexed | 2024-04-09T13:29:58Z |
| format | Article |
| id | doaj.art-ccfa1b371eab4a7887fcb8e7ed065477 |
| institution | Directory Open Access Journal |
| issn | 2466-0493 2466-054X |
| language | English |
| last_indexed | 2024-04-09T13:29:58Z |
| publishDate | 2023-05-01 |
| publisher | Korean Urological Association |
| record_format | Article |
| series | Investigative and Clinical Urology |
| spelling | doaj.art-ccfa1b371eab4a7887fcb8e7ed0654772023-05-10T04:52:22ZengKorean Urological AssociationInvestigative and Clinical Urology2466-04932466-054X2023-05-0164324225410.4111/icu.20230058Cytoreductive prostatectomy may improve oncological outcomes in patients with oligometastatic prostate cancer: An updated systematic review and meta-analysisDoo Yong Chung0https://orcid.org/0000-0001-8614-5742Dong Hyuk Kang 1https://orcid.org/0000-0002-0814-7336Hae Do Jung2https://orcid.org/0000-0002-8287-585XJoo Yong Lee3https://orcid.org/0000-0002-3470-1767Do Kyung Kim 4https://orcid.org/0000-0002-3696-8756Jee Soo Ha5https://orcid.org/0000-0002-3923-4619Jinhyung Jeon6https://orcid.org/0000-0001-8663-1310Kang Su Cho 7https://orcid.org/0000-0002-3500-8833Department of Urology, Inha University College of Medicine, Incheon, Korea.Department of Urology, Inha University College of Medicine, Incheon, Korea.Department of Urology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.Department of Urology, Prostate Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.Department of Urology, Prostate Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.Department of Urology, Prostate Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.The oncologic outcomes of cytoreductive prostatectomy (CRP) in oligometastatic prostate cancer (OmPCa) are still controversial. Therefore, we conducted a systematic review and meta-analysis on the oncologic outcome of CRP in OmPCa. OVID-Medline, OVID-Embase, and Cochrane Library databases were searched to identify eligible studies published before January 2023. A total of 11 studies (929 patients), 1 randomized controlled trial (RCT) and 10 non-RCT studies, were included in the final analysis. RCT and non-RCT were further analyzed separately. End points were progression-free-survival (PFS), time to castration-resistant prostate cancer (CRPCa), cancer-specific-survival (CSS) and overall-survival (OS). It was analyzed using hazard ratio (HR) and 95% confidence intervals (CIs). In PFS, in RCT, HR=0.43 (CIs=0.27–0.69) was shown statistically significant, but in non-RCTs, HR=0.50 (CIs=0.20–1.25), there was no statistical difference. And, in time to CRPCa was statistically significant in the CRP group in all analyses (RCT; HR=0.44; CIs=0.29–0.67) (non-RCTs; HR=0.64; CIs=0.47–0.88). Next, CSS was not statistically different between the two groups (HR=0.63; CIs=0.37–1.05). Finally, OS showed better results in the CRP group in all analyses (RCT; HR=0.44; CIs=0.26–0.76) (non-RCTs; HR=0.59; CIs=0.37–0.93). Patients who received CRP in OmPCa showed better oncologic outcomes compared to controls. Notably, time to CRPC and OS showed significantly improved compared with control. We recommend that experienced urologists who are capable of managing complications consider CRP as a strategy to achieve good oncological outcomes in OmPCa. However, since most of the included studies are non-RCT studies, caution should be exercised in interpreting the results.https://www.icurology.org/pdf/10.4111/icu.20230058cytoreduction surgical proceduresneoplasm metastasisprostatectomyprostatic neoplasmsradiotherapy |
| spellingShingle | Doo Yong Chung Dong Hyuk Kang Hae Do Jung Joo Yong Lee Do Kyung Kim Jee Soo Ha Jinhyung Jeon Kang Su Cho Cytoreductive prostatectomy may improve oncological outcomes in patients with oligometastatic prostate cancer: An updated systematic review and meta-analysis Investigative and Clinical Urology cytoreduction surgical procedures neoplasm metastasis prostatectomy prostatic neoplasms radiotherapy |
| title | Cytoreductive prostatectomy may improve oncological outcomes in patients with oligometastatic prostate cancer: An updated systematic review and meta-analysis |
| title_full | Cytoreductive prostatectomy may improve oncological outcomes in patients with oligometastatic prostate cancer: An updated systematic review and meta-analysis |
| title_fullStr | Cytoreductive prostatectomy may improve oncological outcomes in patients with oligometastatic prostate cancer: An updated systematic review and meta-analysis |
| title_full_unstemmed | Cytoreductive prostatectomy may improve oncological outcomes in patients with oligometastatic prostate cancer: An updated systematic review and meta-analysis |
| title_short | Cytoreductive prostatectomy may improve oncological outcomes in patients with oligometastatic prostate cancer: An updated systematic review and meta-analysis |
| title_sort | cytoreductive prostatectomy may improve oncological outcomes in patients with oligometastatic prostate cancer an updated systematic review and meta analysis |
| topic | cytoreduction surgical procedures neoplasm metastasis prostatectomy prostatic neoplasms radiotherapy |
| url | https://www.icurology.org/pdf/10.4111/icu.20230058 |
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