Role of preoperative hormone therapy in localised prostate cancer:Meta-analysis based on six randomized controlled trials / 中国组织工程研究

ABSTRACT

BACKGROUND:Previous research has demonstrated that preoperative hormone therapy relieved clinicaI and pathological stages of prostatic carcinoma patients,reduced positive ratio of incisaI marginhowever,it did not increase disease-free surviva J rate.Worth of preoperative hormone therapy for prostatic carcinoma remains unclear.OBJECTIVE:To assess the role of preoperative hormone therapy in localised prostate cancer.METHODS:Articles were searched from PubMed,Embase.Cochrane Library(No.4,2009),Chinese biomedicaf literature database,Chinese Scientific Journals full_text database,and Chinese Journal full-text database(published before October,2009).Randomized controlled trials which were diagnosed as Iocalised prostate cancer using pathology and cytology were included The sex and nationality were not limited.and patients did not have severe heart and lung diseases Prostatic carcinoma which occurred Later or repeatedly was excluded.Otherwise.randomized controlled trails which were coincidence with the inclusion criteria were also included.Review Manager 5.0 published by Cochrane was used for stafistical analysis.Overall survival rate.disease-free survivaI rate,positive surgical margin rate,positive lymph node rate.and seminal vesicle invasion rate were evaluated.RESULTS AND CONCLUSlONSix randomized controlled trials totaling 1 027 padicipants were included.The result of meta analysis showed that there was no significant difference in overall surviva J rate[RR=0.94,95%C,(0.86,1.02)],disease-free survival rate[RR=1.02,95%CI(0.89,1.17)],positive lymph node rate IRR=0.86,95%CI(0.47,1.57)],and seminal vesicle invasion rate[RR=1.09,95%CI(0.74,1.59)]between single prostatectomy and preoperative hormone therapy plus prostatectomy,while there was significant difference in positive surgical margin rate[RR=0.46,95%CI(0.32,0.66)]This suggested that preoperative hormonal therapy prior to prostatectomy did not improve survival rate,positive lymph nodes rate and seminaI vesicle invasion ratehowever.there was a significant reduction in the positive surgicaI margin rate.