Sung Ryul Shim1, Karan J K Kanhai2, Young Myoung Ko3, Jae Heon Kim4. 1. Institute for Clinical Molecular Biology Research, Soonchunhyang University Hospital, Sonchunhyang University College of Medicine, Seoul, Republic of Korea. 2. Medical Affairs Department, Astellas Pharma Europe, Middle East and Africa, Chertsey, United Kingdom. 3. Department of Industrial and Management Engineering, Pohang University of Science and Technology, Pohang, Republic of Korea. 4. Department of Urology, Soonchunhyang University Hospital, Sonchunhyang University College of Medicine, Seoul, Republic of Korea. Electronic address: piacekjh@hanmail.net.
Abstract
PURPOSE: This study attempted to overcome the limitations of previous systematic reviews to determine the overall treatment efficacy and safety of prostatic arterial embolization compared with standard therapy. MATERIALS AND METHODS: Meta-analyses were done of randomized, controlled and single group trials. Meta-regression analysis of the moderator effect was performed with single group analysis. The outcomes measured were mean changes in I-PSS (International Prostate Symptom Score), quality of life, maximal urinary flow rate, prostate volume, post-void residual volume and prostate specific antigen. Adverse events were compared as proportional differences between the embolization group and groups receiving other therapies in comparative studies. RESULTS: A total of 16 studies met our selection criteria and were included in the meta-analysis. Three studies were comparative and included a total of 297 subjects, including 149 in the experimental groups and 148 in the control groups. The other 13 studies were noncomparative and included a total of 750 experimental subjects. Pooled overall standardized mean differences for embolization in I-PSS, maximal urinary flow rate and prostate volume were significantly impaired in the experimental vs control groups. Overall weighted mean differences for all outcomes except prostate specific antigen were significantly improved from baseline by embolization treatment in noncomparative studies. Sensitivity analysis of study duration showed that all outcome measurements did not differ before vs after 6 months. CONCLUSIONS: Although there is growing evidence of the efficacy and safety of prostatic arterial embolization for benign prostatic hyperplasia, this systematic review using meta-analysis and meta-regression showed that prostatic arterial embolization should still be considered an experimental treatment modality.
PURPOSE: This study attempted to overcome the limitations of previous systematic reviews to determine the overall treatment efficacy and safety of prostatic arterial embolization compared with standard therapy. MATERIALS AND METHODS: Meta-analyses were done of randomized, controlled and single group trials. Meta-regression analysis of the moderator effect was performed with single group analysis. The outcomes measured were mean changes in I-PSS (International Prostate Symptom Score), quality of life, maximal urinary flow rate, prostate volume, post-void residual volume and prostate specific antigen. Adverse events were compared as proportional differences between the embolization group and groups receiving other therapies in comparative studies. RESULTS: A total of 16 studies met our selection criteria and were included in the meta-analysis. Three studies were comparative and included a total of 297 subjects, including 149 in the experimental groups and 148 in the control groups. The other 13 studies were noncomparative and included a total of 750 experimental subjects. Pooled overall standardized mean differences for embolization in I-PSS, maximal urinary flow rate and prostate volume were significantly impaired in the experimental vs control groups. Overall weighted mean differences for all outcomes except prostate specific antigen were significantly improved from baseline by embolization treatment in noncomparative studies. Sensitivity analysis of study duration showed that all outcome measurements did not differ before vs after 6 months. CONCLUSIONS: Although there is growing evidence of the efficacy and safety of prostatic arterial embolization for benign prostatic hyperplasia, this systematic review using meta-analysis and meta-regression showed that prostatic arterial embolization should still be considered an experimental treatment modality.
Authors: J Curtis Nickel; Lorne Aaron; Jack Barkin; Dean Elterman; Mahmoud Nachabé; Kevin C Zorn Journal: Can Urol Assoc J Date: 2018-10 Impact factor: 1.862
Authors: U B Liehr; D Baumunk; S Blaschke; F Fischbach; B Friebe; F König; A Lemke; P Mittelstädt; M Pech; M Porsch; J Ricke; D Schindele; S Siedentopf; J J Wendler; M Schostak Journal: Radiologe Date: 2017-08 Impact factor: 0.635