Effects of Delayed Radical Prostatectomy and Active Surveillance on Localised Prostate Cancer—A Systematic Review and Meta-Analysis
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Literature Search
2.2. Selection Criteria
2.3. Screening and Data Extraction
2.4. Data Synthesis and Statistical Analysis
3. Results
3.1. Literature Search Results
3.2. Expectant Management
3.2.1. Outcomes in Mixed Risks Patients
3.2.2. Outcomes Stratified by Risks
3.3. Observational Studies on Delay of RP
3.3.1. Low Risk Patients
3.3.2. Intermediate-Risk Patients
3.3.3. High-Risk Patients
3.4. Use of Neoadjuvant Hormone Replacement Therapy
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Outcome | No. of Studies | Risk Ratio | 95% CI | p-Value |
---|---|---|---|---|
Overall Deaths | 4 | 1.30 | 0.81–2.09 | 0.28 |
Cancer-specific Deaths | 4 | 1.25 | 0.46–3.40 | 0.66 |
Positive Surgical Margin | 10 | 0.45 | 0.37–0.54 | <0.01 |
Organ Confinement | 6 | 1.39 | 1.10–1.76 | <0.01 |
Lymph node involvement | 6 | 0.68 | 0.48–0.97 | 0.03 |
Seminal Vesicle involvement | 3 | 1.02 | 0.44–2.32 | 0.97 |
Pathological Upstaging | 2 | 0.51 | 0.34–0.76 | <0.01 |
Pathological Down-staging | 3 | 2.38 | 1.49–3.78 | <0.01 |
PSA Failure | 5 | 0.96 (HR) | 0.78–1.19 | 0.72 |
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Chan, V.W.-S.; Tan, W.S.; Asif, A.; Ng, A.; Gbolahan, O.; Dinneen, E.; To, W.; Kadhim, H.; Premchand, M.; Burton, O.; et al. Effects of Delayed Radical Prostatectomy and Active Surveillance on Localised Prostate Cancer—A Systematic Review and Meta-Analysis. Cancers 2021, 13, 3274. https://doi.org/10.3390/cancers13133274
Chan VW-S, Tan WS, Asif A, Ng A, Gbolahan O, Dinneen E, To W, Kadhim H, Premchand M, Burton O, et al. Effects of Delayed Radical Prostatectomy and Active Surveillance on Localised Prostate Cancer—A Systematic Review and Meta-Analysis. Cancers. 2021; 13(13):3274. https://doi.org/10.3390/cancers13133274
Chicago/Turabian StyleChan, Vinson Wai-Shun, Wei Shen Tan, Aqua Asif, Alexander Ng, Olayinka Gbolahan, Eoin Dinneen, Wilson To, Hassan Kadhim, Melissa Premchand, Oliver Burton, and et al. 2021. "Effects of Delayed Radical Prostatectomy and Active Surveillance on Localised Prostate Cancer—A Systematic Review and Meta-Analysis" Cancers 13, no. 13: 3274. https://doi.org/10.3390/cancers13133274