BACKGROUND: The aim of this study was to compare oncologic outcomes of radical prostatectomy (RP) with brachytherapy (BT). METHODS: A literature review was conducted according to the 'Preferred reporting items for systematic reviews and meta-analyses' (PRISMA) statement. We included studies reporting comparative oncologic outcomes of RP versus BT for localized prostate cancer (PCa). From each comparative study, we extracted the study design, the number and features of the included patients, and the oncologic outcomes expressed as all-cause mortality (ACM), PCa-specific mortality (PCSM) or, when the former were unavailable, as biochemical recurrence (BCR). All of the data retrieved from the selected studies were recorded in an electronic database. Cumulative analysis was conducted using the Review Manager version 5.3 software, designed for composing Cochrane Reviews (Cochrane Collaboration, Oxford, UK). Statistical heterogeneity was tested using the Chi-square test. RESULTS: Our cumulative analysis did not show any significant difference in terms of BCR, ACM or PCSM rates between the RP and BT cohorts. Only three studies reported risk-stratified outcomes of intermediate- and high-risk patients, which are the most prone to treatment failure. CONCLUSIONS: our analysis suggested that RP and BT may have similar oncologic outcomes. However, the analysis included a limited number of studies, and most of them were retrospective, making it impossible to derive any definitive conclusion, especially for intermediate- and high-risk patients. In this scenario, appropriate urologic counseling remains of utmost importance.
BACKGROUND: The aim of this study was to compare oncologic outcomes of radical prostatectomy (RP) with brachytherapy (BT). METHODS: A literature review was conducted according to the 'Preferred reporting items for systematic reviews and meta-analyses' (PRISMA) statement. We included studies reporting comparative oncologic outcomes of RP versus BT for localized prostate cancer (PCa). From each comparative study, we extracted the study design, the number and features of the included patients, and the oncologic outcomes expressed as all-cause mortality (ACM), PCa-specific mortality (PCSM) or, when the former were unavailable, as biochemical recurrence (BCR). All of the data retrieved from the selected studies were recorded in an electronic database. Cumulative analysis was conducted using the Review Manager version 5.3 software, designed for composing Cochrane Reviews (Cochrane Collaboration, Oxford, UK). Statistical heterogeneity was tested using the Chi-square test. RESULTS: Our cumulative analysis did not show any significant difference in terms of BCR, ACM or PCSM rates between the RP and BT cohorts. Only three studies reported risk-stratified outcomes of intermediate- and high-risk patients, which are the most prone to treatment failure. CONCLUSIONS: our analysis suggested that RP and BT may have similar oncologic outcomes. However, the analysis included a limited number of studies, and most of them were retrospective, making it impossible to derive any definitive conclusion, especially for intermediate- and high-risk patients. In this scenario, appropriate urologic counseling remains of utmost importance.
Authors: Vincenzo Ficarra; Giacomo Novara; Thomas E Ahlering; Anthony Costello; James A Eastham; Markus Graefen; Giorgio Guazzoni; Mani Menon; Alexandre Mottrie; Vipul R Patel; Henk Van der Poel; Raymond C Rosen; Ashutosh K Tewari; Timothy G Wilson; Filiberto Zattoni; Francesco Montorsi Journal: Eur Urol Date: 2012-06-01 Impact factor: 20.096
Authors: John W Colberg; Roy H Decker; Anwar M Khan; Ann McKeon; Lynn D Wilson; Richard E Peschel Journal: Cancer J Date: 2007 Jul-Aug Impact factor: 3.360
Authors: Vincenzo Ficarra; Giacomo Novara; Raymond C Rosen; Walter Artibani; Peter R Carroll; Anthony Costello; Mani Menon; Francesco Montorsi; Vipul R Patel; Jens-Uwe Stolzenburg; Henk Van der Poel; Timothy G Wilson; Filiberto Zattoni; Alexandre Mottrie Journal: Eur Urol Date: 2012-06-01 Impact factor: 20.096
Authors: Jerrold Sharkey; Alan Cantor; Zucel Solc; William Huff; Stanley D Chovnick; Raymond J Behar; Ramon Perez; Juan Otheguy; Richard Rabinowitz Journal: Brachytherapy Date: 2005 Impact factor: 2.362
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Authors: Padraig Warde; Malcolm Mason; Keyue Ding; Peter Kirkbride; Michael Brundage; Richard Cowan; Mary Gospodarowicz; Karen Sanders; Edmund Kostashuk; Greg Swanson; Jim Barber; Andrea Hiltz; Mahesh K B Parmar; Jinka Sathya; John Anderson; Charles Hayter; John Hetherington; Matthew R Sydes; Wendy Parulekar Journal: Lancet Date: 2011-11-02 Impact factor: 79.321