PDF(Pubmed)
Abstract：
UNASSIGNED: This meta-analysis was to investigate the effects of neoadjuvant chemohormonal therapy (NCHT) on patients with prostate cancer (PCa) before radical prostatectomy (RP) and attempt to provide meaningful evidence.
UNASSIGNED: A systematic search was performed using the PubMed, Web of Science, and Cochrane Library databases in February 2022 based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The relevant studies were critically screened and we extracted the data of demography, postoperative pathology, and survival to calculate the pooled effect sizes. Subgroup analyses and sensitivity analyses were used to explore the source of heterogeneity.
UNASSIGNED: Six identified studies involving 1717 subjects were included according to the selection criteria. There was no significant difference between NCHT plus RP and RP alone groups regarding lymph node involvement (risk ratio [RR]=1.03, 95% confidence interval [CI]: 0.57-1.87, P=0.92). However, NCHT prior to RP significantly decreased the rates of positive surgical margin (PSM, RR=0.35, 95% CI: 0.22-0.55, P<0.0001) and seminal vesicle invasion (SVI, RR=0.78, 95% CI: 0.65-0.95, P=0.01), and increase pathological downstaging (RR=1.64, 95% CI: 1.17-2.29, P=0.004). Additionally, biochemical recurrence-free survival (BRFS) and overall survival (OS) were significantly prolonged under the administration of NCHT (HR=0.54, 95% CI: 0.34-0.85, P=0.008 and HR=0.67, 95% CI: 0.48-0.94, P=0.02, respectively).
UNASSIGNED: Compared to the RP alone group, patients with NCHT plus RP showed significant improvements in PSM, SVI, pathological downstaging, BRFS, and OS, whereas further multicenter randomized controlled trials are needed to consolidate this concept.
UNASSIGNED: A systematic search was performed using the PubMed, Web of Science, and Cochrane Library databases in February 2022 based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The relevant studies were critically screened and we extracted the data of demography, postoperative pathology, and survival to calculate the pooled effect sizes. Subgroup analyses and sensitivity analyses were used to explore the source of heterogeneity.
UNASSIGNED: Six identified studies involving 1717 subjects were included according to the selection criteria. There was no significant difference between NCHT plus RP and RP alone groups regarding lymph node involvement (risk ratio [RR]=1.03, 95% confidence interval [CI]: 0.57-1.87, P=0.92). However, NCHT prior to RP significantly decreased the rates of positive surgical margin (PSM, RR=0.35, 95% CI: 0.22-0.55, P<0.0001) and seminal vesicle invasion (SVI, RR=0.78, 95% CI: 0.65-0.95, P=0.01), and increase pathological downstaging (RR=1.64, 95% CI: 1.17-2.29, P=0.004). Additionally, biochemical recurrence-free survival (BRFS) and overall survival (OS) were significantly prolonged under the administration of NCHT (HR=0.54, 95% CI: 0.34-0.85, P=0.008 and HR=0.67, 95% CI: 0.48-0.94, P=0.02, respectively).
UNASSIGNED: Compared to the RP alone group, patients with NCHT plus RP showed significant improvements in PSM, SVI, pathological downstaging, BRFS, and OS, whereas further multicenter randomized controlled trials are needed to consolidate this concept.
摘要：
■这项荟萃分析旨在研究前列腺癌（PCa）患者在前列腺癌根治术（RP）之前接受新辅助化疗（NCHT）的效果，并试图提供有意义的证据。
■使用PubMed进行了系统搜索，WebofScience,和CochraneLibrary数据库于2022年2月基于系统审查和荟萃分析指南的首选报告项目。对相关研究进行了严格的筛选，我们提取了人口学数据，术后病理，和生存率来计算合并效应大小。亚组分析和敏感性分析用于探索异质性的来源。
■根据选择标准，纳入了涉及1717名受试者的六项确定的研究。NCHT加RP组和单纯RP组淋巴结受累无显著差异（风险比[RR]=1.03，95%置信区间[CI]：0.57-1.87，P=0.92）。然而,RP之前的NCHT显着降低了手术切缘阳性的发生率（PSM，RR=0.35，95%CI：0.22-0.55，P<0.0001）和精囊浸润（SVI，RR=0.78，95%CI：0.65-0.95，P=0.01），并增加病理分期(RR=1.64,95%CI:1.17-2.29,P=0.004)。此外,NCHT治疗后生化无复发生存期(BRFS)和总生存期(OS)显著延长(HR=0.54,95%CI:0.34~0.85,P=0.008,HR=0.67,95%CI:0.48~0.94,P=0.02).
■与单纯RP组相比，NCHT+RP患者的PSM显着改善，SVI,病理降级，BRFS,和操作系统，而需要进一步的多中心随机对照试验来巩固这一概念.
■使用PubMed进行了系统搜索，WebofScience,和CochraneLibrary数据库于2022年2月基于系统审查和荟萃分析指南的首选报告项目。对相关研究进行了严格的筛选，我们提取了人口学数据，术后病理，和生存率来计算合并效应大小。亚组分析和敏感性分析用于探索异质性的来源。
■根据选择标准，纳入了涉及1717名受试者的六项确定的研究。NCHT加RP组和单纯RP组淋巴结受累无显著差异（风险比[RR]=1.03，95%置信区间[CI]：0.57-1.87，P=0.92）。然而,RP之前的NCHT显着降低了手术切缘阳性的发生率（PSM，RR=0.35，95%CI：0.22-0.55，P<0.0001）和精囊浸润（SVI，RR=0.78，95%CI：0.65-0.95，P=0.01），并增加病理分期(RR=1.64,95%CI:1.17-2.29,P=0.004)。此外,NCHT治疗后生化无复发生存期(BRFS)和总生存期(OS)显著延长(HR=0.54,95%CI:0.34~0.85,P=0.008,HR=0.67,95%CI:0.48~0.94,P=0.02).
■与单纯RP组相比，NCHT+RP患者的PSM显着改善，SVI,病理降级，BRFS,和操作系统，而需要进一步的多中心随机对照试验来巩固这一概念.
