Local treatment for the prognosis of hormone-sensitive metastatic prostate cancer: a Meta-analysis

Abstract

Objective To evaluate the effect of local treatment for the prognosis of hormone-sensitive metastatic prostate cancer. Methods A systematic review of the literature about local treatment for the prognosis of hormone-sensitive metastatic prostate cancer was performed, searching Medline, Embase, Cochrane Library, CBM, CNKI, VIP and Wan Fang database from January 2001 to October 2016. Two authors reviewed the records to identify comparative studies. A meta-analysis was conducted using Review Manager 5.0. Results Five studies were enrolled, including 29 354 patients. Meta-analysis showed that, compared with no local treatment, local treatment had a significant beneficial effect in 5-year overall survival rate (OR=0.18, 95%CI 0.15-0.22, P<0.01), 5-year disease specific survival rate(OR=0.39, 95%CI 0.31-0.49, P<0.01) as well as 3-year overall survival rate (OR=0.47, 95%CI 0.35-0.62, P<0.01). Sub-group analysis showed that, compared with no local treatment, prostatectomy had a significant beneficial effect in 5-year overall survival rate(OR=0.17, 95%CI 0.12-0.25, P<0.01), 5-year disease specific survival rate (OR=0.30, 95%CI 0.22-0.40, P<0.01) as well as 3-year overall survival rate (OR=0.25, 95%CI 0.19-0.32 , P<0.01), and external beam radiation therapy only had a significant beneficial effect in 3-year overall survival rate (OR=0.54, 95%CI 0.42-0.69, P<0.01). Conclusions Prostatectomy and external beam radiation therapy may have a survival benefit for hormone-sensitive metastatic prostate cancer. Prospective randomized controlled studies are necessary because of the limits of current studies. Key words: Prostatic neoplasms, metastatic; Local treatment; Radical prostatectomy; Radiotherapy; Meta-analysis