AB103. Prostatectomy versus active surveillance for early stage prostate cancer: a meta-analysis
Abstract publication Urology

AB103. Prostatectomy versus active surveillance for early stage prostate cancer: a meta-analysis

You Luo, Shengjun Fu, Li Yang

Gansu Province Key Laboratory of Department of Urology, The Urology Clinical Medical Center, Department of Urology of Lanzhou University Second Hospital, Lanzhou 730000, China; Graduate school of Lanzhou University Second Hospital, Lanzhou 730000, China; Urological Research Institute of Lanzhou University Second Hospital, Lanzhou 730000, China

Objective: To compare the survival effect between radical prostatectomy (RP) and active surveillance (AS) for the treatment of early stage prostate cancer.

Method: Randomized controlled trials were computerized searched from Medline, Cochrane Library, ISI web of knowledge, Science Direct, Google scholar, CBM database for the evaluation of prognosis of treatment for early stage prostate cancer—RP versus AS. Prognosis of the treatment includes all-cause mortality, prostate cancer specific mortality and cancer metastasis. The latest retrieval date was May 2014. The data was extracted and the quality of included studies was independently assessed by two reviewers and RevMan5.2 software was used to perform data synthesis.

Result: Three RCTs involving 1,537 patients (772 RP vs. 765 AS) were included finally. The results of meta-analysis displayed that the hazard of all-cause mortality in RP group was significantly lower than AS group, HR =0.79 (95% CI, 0.69-0.90, P=0.0005), no significant difference was seen in <65 years group or ≥65 years group. Prostate cancer specific mortality risk was HR =0.58 (95% CI, 0.44-0.76), P=0.0001). And subgroup analysis showed RP protect patients from cancer specific mortality by age under 65 years, HR=0.46 (95% CI, 0.31-0.68, P=0.0001), no significant difference in patients above 65 years. Hazard of tumor metastasis was lower in RP group than in AS group regardless of age stratification, HR =0.54 (95% CI, 0.42-0.68, P<0.00001).

Conclusions: Radical prostatectomy reduced hazard of all-cause mortality, cancer specific mortality and cancer metastasis, and the benefit to prostate cancer survival was mainly manifested in patients under age 65 years. After combining patient expectant survival assessment and quality of life, active surveillance was still an effective management protocol for early stage prostate cancer.

Keywords: Early stage prostate cancer; radical prostatectomy; active surveillance (AS); survival analysis; systematic review; meta-analysis

doi: 10.3978/j.issn.2223-4683.2014.s103

Cite this article as: Luo Y, Fu S, Yang L. Prostatectomy versus active surveillance for early stage prostate cancer: a meta-analysis. Transl Androl Urol 2014;3(S1):AB103. doi: 10.3978/j.issn.2223-4683.2014.s103

Article Options

Download Citation

Share