Impact of local treatment on overall survival of patients with metastatic prostate cancer: systematic review and meta-analysis

ABSTRACT Context Currently, standard treatment of metastatic prostatic cancer (MPCa) is androgen-deprivation therapy (ADT). Recent studies suggested that local treatment of MPCa is related to increase of survival of those patients, as observed in other tumors. Objective To evaluate the impact of local treatment on overall survival and cancer specific survival in 3 and 5 years in patients with MPCa. Materials and Methods Systematic review and meta-analysis of population studies published at PubMed, Scielo, Lilacs, Cochrane and EMBASE databases until June 2016. Several large cohorts and Post-Roc studies were included, that evaluated patients with MPCa submitted to local treatment (LT) using radiotherapy (RDT), surgery (RP) or brachytherapy (BCT) or not submitted to local treatment (NLT). Results 34.338 patients were analyzed in six included papers, 31.653 submitted to NLT and 2.685 to LT. Overall survival in three years was significantly higher in patients submitted to LT versus NLT (64.2% vs. 44.5%; RD 0.19, 95% CI, 0.17-0.21; p

摘要
背景：目前，转移性前列腺癌（metastatic prostatic cancer, MPCa）的标准治疗方案为雄激素剥夺疗法（androgen-deprivation therapy, ADT）。近期研究表明，与其他肿瘤的相关研究结果一致，转移性前列腺癌的局部治疗与患者生存期延长存在相关性。
研究目的：评估局部治疗对转移性前列腺癌患者3年及5年总生存期与癌症特异性生存期的影响。
材料与方法：对截至2016年6月发表于PubMed、Scielo、Lilacs、Cochrane及EMBASE数据库的人群研究开展系统综述与荟萃分析。纳入多项大型队列研究及Post-Roc研究，评估接受局部治疗（local treatment, LT）——包括放疗（radiotherapy, RDT）、手术（RP）或近距离放射治疗（brachytherapy, BCT）——或未接受局部治疗（non-local treatment, NLT）的转移性前列腺癌患者的临床结局。
结果：共纳入6篇文献，共计分析34338例患者，其中31653例接受NLT，2685例接受LT。接受LT的患者3年总生存期显著优于NLT组（64.2% vs. 44.5%；RD=0.19，95%置信区间（confidence interval, CI）：0.17~0.21；P<