前列腺根治性切除术对M1c期前列腺癌患者生存影响的Meta分析

The effect on survival of radical prostatectomy in patients with M1c prostate cancer:a Meta-a-nalysis

目的系统性评价前列腺根治性切除术(RP)对M1c期前列腺癌(PCa)患者生存的影响。方法计算机检索Pubmed、Embase、Science Direct、中国知网、维普、万方数据库中关于M1c期PCa患者行RP和非局部治疗的生存对比研究。检索时间均从建库至2019年4月。由两名评价员共同评价纳人研究的质量,采用STATA11.0软件对两种治疗方法下患者生存的影响进行Meta分析。结果纳人3篇回顾性研究。包括4771例患者,RP组151例,非局部治疗组4620例。Meta分析结果显示,与非局部治疗组相比,RP组患者整体病死率降低(HR=0.27,95%CI:0.20~0.36,P<0.01),肿瘤特异性病死率降低(HR=0.32,95%CI:0.21~0.51,P<0.01),差异均具有统计学意义。结论M1c期PCa患者采用rP治疗可能改善生存预后,需要更多的前瞻性随机对照研究进一步验证。

Objective To evaluate the survival effect of radical prostatectomy(RP)for the M1c prostate cancer(PCa).Methods A systematic review of the literature about RP for the survival effect of M1c PCa was performed,searching Pubmed,Embase,ScienceDirect,CNKI,VIP and WanFang database from databases establishment to April 2019.Two authors reviewed the records to identify comparative studies.A Meta-analysis was conducted using STATA 11.0.Results Three studies were enrolled,which consisted of 4771 patients including 151 cases in experimental group,4620 cases in control group.Meta-analysis showed that,compared with no local treatment,radical prostatectomy had a significant beneficial effect in overall mortality rat(HR=0.27,95%CI:0.20-0.36,P<0.01),as well as cancer specific mortality rat(HR=0.32,95%CI:0.21-0.51,P<0.01).Conclusions RP may have a survival benefit for Mlc PCa.Prospective randomized controlled studies are necessary because of the limits of current studies.