The impact of surgical margin status on prostate cancer-specific mortality after radical prostatectomy: a systematic review and meta-analysis.
Meta-analysis
Prostate cancer-specific mortality
Radical prostatectomy
Surgical margin status
Journal
Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
ISSN: 1699-3055
Titre abrégé: Clin Transl Oncol
Pays: Italy
ID NLM: 101247119
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
21
12
2019
accepted:
28
04
2020
pubmed:
16
5
2020
medline:
8
7
2021
entrez:
16
5
2020
Statut:
ppublish
Résumé
Until now, there is no clear conclusion on the relationship between the surgical margin status after radical prostatectomy (RP) and prostate cancer-specific mortality (PCSM). Therefore, we conducted this systematic review and meta-analysis based on all eligible case-control studies. A systematic and comprehensive literature search was performed based on PUBMED and EMBASE to identify all of the potentially relevant publications which were published before September 2019. Hazard ratio (HR) for PCSM was independently extracted by two reviewers from all eligible studies. Pooled HR estimates with their corresponding 95% confidence intervals (95% CIs) were computed by Stata12.0. Total 15 eligible studies were included in this meta-analysis. The pooled results showed that patients with positive surgical margin (PSM) after RP may have higher PCSM than those who had a negative surgical margin (HR 1.44, P = 0.043). In the subgroup analysis, we found that no matter whether the pathological stage of the patients is T2 or T3, PSM is indicative of a high PCSM and that the PCSM of T3 is higher than T2 (Pathological stage T3, HR 1.77, P = 0.032; Pathological stage T2, HR 1.56, P = 0.003). In addition, by performing the subgroup analysis of Gleason score, we concluded that both Gleason score 8-10 and Gleason score ≤ 7 would increase the risk of PCSM, and the former was more significant than the latter (Gleason score 8-10, HR 1.88, P < 0.001; Gleason score ≤ 7, HR 1.38, P = 0.039). Moreover, PSM increased PCSM regardless of whether the patients received radiation therapy or not (radiation therapy, HR 1.92, P < 0.001; no radiation therapy, HR 1.42, P < 0.001). This meta-analysis demonstrated that patients with PSM after RP may have an elevated PCSM. However, to evaluate these correlations in more details, it is necessary to conduct further studies on a larger sample size.
Sections du résumé
BACKGROUND
BACKGROUND
Until now, there is no clear conclusion on the relationship between the surgical margin status after radical prostatectomy (RP) and prostate cancer-specific mortality (PCSM). Therefore, we conducted this systematic review and meta-analysis based on all eligible case-control studies.
METHODS
METHODS
A systematic and comprehensive literature search was performed based on PUBMED and EMBASE to identify all of the potentially relevant publications which were published before September 2019. Hazard ratio (HR) for PCSM was independently extracted by two reviewers from all eligible studies. Pooled HR estimates with their corresponding 95% confidence intervals (95% CIs) were computed by Stata12.0.
RESULTS
RESULTS
Total 15 eligible studies were included in this meta-analysis. The pooled results showed that patients with positive surgical margin (PSM) after RP may have higher PCSM than those who had a negative surgical margin (HR 1.44, P = 0.043). In the subgroup analysis, we found that no matter whether the pathological stage of the patients is T2 or T3, PSM is indicative of a high PCSM and that the PCSM of T3 is higher than T2 (Pathological stage T3, HR 1.77, P = 0.032; Pathological stage T2, HR 1.56, P = 0.003). In addition, by performing the subgroup analysis of Gleason score, we concluded that both Gleason score 8-10 and Gleason score ≤ 7 would increase the risk of PCSM, and the former was more significant than the latter (Gleason score 8-10, HR 1.88, P < 0.001; Gleason score ≤ 7, HR 1.38, P = 0.039). Moreover, PSM increased PCSM regardless of whether the patients received radiation therapy or not (radiation therapy, HR 1.92, P < 0.001; no radiation therapy, HR 1.42, P < 0.001).
CONCLUSIONS
CONCLUSIONS
This meta-analysis demonstrated that patients with PSM after RP may have an elevated PCSM. However, to evaluate these correlations in more details, it is necessary to conduct further studies on a larger sample size.
Identifiants
pubmed: 32410119
doi: 10.1007/s12094-020-02358-y
pii: 10.1007/s12094-020-02358-y
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
2087-2096Subventions
Organisme : Tianjin Science and Technology Committee
ID : 19ZXDBSY00050