Local treatment benefits patients with oligometastatic prostate cancer: A systematic review and meta-analysis

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY International Journal of Urology Pub Date : 2024-07-16 DOI:10.1111/iju.15540

Qihao Sun, Kun Du, Shulei Sun, Yuxin Liu, Houtao Long, Daofeng Zhang, Junhao Zheng, Xiaoliang Sun, Yong Zhao, Haiyang Zhang

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Abstract

Objectives

This study aims to evaluate the efficacy of local treatment (LT), including radiotherapy (RT) and cytoreductive prostatectomy (CRP), in improving outcomes for patients with oligometastatic prostate cancer (OmPCa).

Methods

A systematic review and meta-analysis of articles from PubMed, Embase, and Web of Science published between 2010 and November 2023 were conducted. The study included 11 articles, comprising three randomized controlled trials (RCTs) and eight retrospective analyses. The study assessed overall survival (OS), radiographic progression-free survival (rPFS), prostate-specific antigen (PSA) PFS, cancer-specific survival (CSS), and complication rate (CR).

Results

OS was significantly improved in the LT group, with both RCTs and non-RCTs showing statistical significance [hazard ratios (HR) = 0.64; 95% confidence intervals (95% CIs), 0.51–0.80; p < 0.0001; HR = 0.55; 95% CIs, 0.40–0.77; p = 0.0004]. For rPFS, RCTs did not show statistically significant outcomes (HR = 0.60; 95% CIs, 0.34–1.07; p = 0.09), whereas non-RCTs demonstrated significant results (HR = 0.42; 95% CIs, 0.24–0.72; p = 0.002). Both RCTs and non-RCTs showed a significant improvement in PSA-PFS (HR = 0.44; 95%CI, 0.29–0.67; p = 0.0001; HR = 0.51; 95% CIs, 0.32–0.81; p = 0.004). For CSS, RCTs demonstrated statistical differences (HR = 0.65; 95% CIs, 0.47–0.90; p = 0.009), whereas non-RCTs did not (HR = 0.61; 95% CIs, 0.29–1.27; p = 0.19). Regarding CR, the risk difference was −0.22 (95% CIs, −0.32 to −0.12; p < 0.00001).

Conclusion

LT significantly improved OS and PFS in patients with OmPCa. Further RCTs are necessary to confirm these results.

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局部治疗有益于少转移性前列腺癌患者：系统回顾和荟萃分析。

研究目的本研究旨在评估局部治疗（LT），包括放射治疗（RT）和细胞修复性前列腺切除术（CRP）在改善寡转移性前列腺癌（OmPCa）患者预后方面的疗效：对2010年至2023年11月期间发表在PubMed、Embase和Web of Science上的文章进行了系统综述和荟萃分析。研究共纳入11篇文章，包括3项随机对照试验（RCT）和8项回顾性分析。研究评估了总生存期（OS）、放射学无进展生存期（rPFS）、前列腺特异性抗原（PSA）无进展生存期、癌症特异性生存期（CSS）和并发症发生率（CR）：结果：LT组的OS明显改善，RCTs和非RCTs均显示出统计学意义[危险比（HR）=0.64；95%置信区间（95% CIs），0.51-0.80；P 结论：LT能明显改善前列腺癌患者的OS和PFS：LT能明显改善OmPCa患者的OS和PFS。有必要进行更多的 RCT 研究来证实这些结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Urology 医学-泌尿学与肾脏学

CiteScore

4.70

自引率

11.50%

发文量

340

审稿时长

3 months

期刊介绍： International Journal of Urology is the official English language journal of the Japanese Urological Association, publishing articles of scientific excellence in urology. Submissions of papers from all countries are considered for publication. All manuscripts are subject to peer review and are judged on the basis of their contribution of original data and ideas or interpretation.