Re: Surgery Versus Radiotherapy for Clinically-localized Prostate Cancer: A Systematic Review and Meta-analysis
DITORIAL COMMENT Radical treatment options for patients with clinically-localized prostate cancer include radical prostatectomy and radiotherapy. Since there is no level 1 evidence comparing the efficacy of these two modalities, Wallis and coworkers conducted a systematic review and meta-analysis...
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| Format: | Article |
| Language: | English |
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Galenos Yayinevi
2016-12-01
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| Series: | Journal of Urological Surgery |
| Online Access: | http://jurolsurgery.org/article_10915/Re-Surgery-Versus-Radiotherapy-For-Clinically-localized-Prostate-Cancer-A-Systematic-Review-And-Meta-analysis |
| _version_ | 1797922699640569856 |
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| author | Özgür Yaycıoğlu |
| author_facet | Özgür Yaycıoğlu |
| author_sort | Özgür Yaycıoğlu |
| collection | DOAJ |
| description | DITORIAL COMMENT
Radical treatment options for patients with clinically-localized prostate cancer include radical prostatectomy and radiotherapy. Since there is no level 1 evidence comparing the efficacy of these two modalities, Wallis and coworkers conducted a systematic review and meta-analysis to compare the data on overall and prostate cancer-specific survival among patients treated with radiotherapy or radical prostatectomy for clinically-localized prostate cancer. Nineteen studies were selected and up to 118.830 patients were pooled. Of note, only two studies provided “dose-escalated” external beam radiotherapy treatments to all radiotherapy patients. The risk of overall (10 studies, aHR 1.63, 95% confidence interval 1.54-1.73, p<0.00001; I2=0%) and prostate cancer-specific (15 studies, aHR 2.08, 95% confidence interval 1.76-2.47, p<0.00001; I2=48%) mortality were higher for patients treated with radiotherapy compared with those treated with surgery. Subgroup analyses by risk group, radiation regimen, time period, and follow-up length did not alter the direction of results. They concluded that radiotherapy for prostate cancer is associated with an increased risk of overall and prostate cancer-specific mortality compared with surgery based on observational data. The methodological limitations of observational studies should be considered while interpreting the results. The ProtecT trial and SPCG-15 trial comparing radical prostatectomy to radiotherapy among patients with low/intermediate and high-risk cancer respectively are awaited. |
| first_indexed | 2024-04-10T14:35:26Z |
| format | Article |
| id | doaj.art-e43eb9587cbe42ebb1eb152738d4a01e |
| institution | Directory Open Access Journal |
| issn | 2148-9580 |
| language | English |
| last_indexed | 2024-04-10T14:35:26Z |
| publishDate | 2016-12-01 |
| publisher | Galenos Yayinevi |
| record_format | Article |
| series | Journal of Urological Surgery |
| spelling | doaj.art-e43eb9587cbe42ebb1eb152738d4a01e2023-02-15T16:08:38ZengGalenos YayineviJournal of Urological Surgery2148-95802016-12-013414914910.4274/jus.2016.03.033Re: Surgery Versus Radiotherapy for Clinically-localized Prostate Cancer: A Systematic Review and Meta-analysisÖzgür YaycıoğluDITORIAL COMMENT Radical treatment options for patients with clinically-localized prostate cancer include radical prostatectomy and radiotherapy. Since there is no level 1 evidence comparing the efficacy of these two modalities, Wallis and coworkers conducted a systematic review and meta-analysis to compare the data on overall and prostate cancer-specific survival among patients treated with radiotherapy or radical prostatectomy for clinically-localized prostate cancer. Nineteen studies were selected and up to 118.830 patients were pooled. Of note, only two studies provided “dose-escalated” external beam radiotherapy treatments to all radiotherapy patients. The risk of overall (10 studies, aHR 1.63, 95% confidence interval 1.54-1.73, p<0.00001; I2=0%) and prostate cancer-specific (15 studies, aHR 2.08, 95% confidence interval 1.76-2.47, p<0.00001; I2=48%) mortality were higher for patients treated with radiotherapy compared with those treated with surgery. Subgroup analyses by risk group, radiation regimen, time period, and follow-up length did not alter the direction of results. They concluded that radiotherapy for prostate cancer is associated with an increased risk of overall and prostate cancer-specific mortality compared with surgery based on observational data. The methodological limitations of observational studies should be considered while interpreting the results. The ProtecT trial and SPCG-15 trial comparing radical prostatectomy to radiotherapy among patients with low/intermediate and high-risk cancer respectively are awaited.http://jurolsurgery.org/article_10915/Re-Surgery-Versus-Radiotherapy-For-Clinically-localized-Prostate-Cancer-A-Systematic-Review-And-Meta-analysis |
| spellingShingle | Özgür Yaycıoğlu Re: Surgery Versus Radiotherapy for Clinically-localized Prostate Cancer: A Systematic Review and Meta-analysis Journal of Urological Surgery |
| title | Re: Surgery Versus Radiotherapy for Clinically-localized Prostate Cancer: A Systematic Review and Meta-analysis |
| title_full | Re: Surgery Versus Radiotherapy for Clinically-localized Prostate Cancer: A Systematic Review and Meta-analysis |
| title_fullStr | Re: Surgery Versus Radiotherapy for Clinically-localized Prostate Cancer: A Systematic Review and Meta-analysis |
| title_full_unstemmed | Re: Surgery Versus Radiotherapy for Clinically-localized Prostate Cancer: A Systematic Review and Meta-analysis |
| title_short | Re: Surgery Versus Radiotherapy for Clinically-localized Prostate Cancer: A Systematic Review and Meta-analysis |
| title_sort | re surgery versus radiotherapy for clinically localized prostate cancer a systematic review and meta analysis |
| url | http://jurolsurgery.org/article_10915/Re-Surgery-Versus-Radiotherapy-For-Clinically-localized-Prostate-Cancer-A-Systematic-Review-And-Meta-analysis |
| work_keys_str_mv | AT ozguryaycıoglu resurgeryversusradiotherapyforclinicallylocalizedprostatecancerasystematicreviewandmetaanalysis |