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- Title
A Systematic Review and Meta-Analysis of the Cancer-Related and Functional Outcomes of High-Intensity Focused Ultrasound, Open Radical Prostatectomy, Robot Assisted Radical Prostatectomy, and External Beam Radiation Therapy in Primary Treatment of Localized Low- or Intermediate-Risk Prostate Cancer
- Authors
Toeama, Bassem; Papadimitropoulos, Emmanuel; Perlis, Nathan; Grootendorst, Paul; Hamandi, Bassem
- Abstract
Objective: Prostate cancer is the second-leading cause of cancer death among men. We aimed to evaluate high-intensity focused ultrasound (HIFU), open radical prostatectomy (ORP), robot-assisted radical prostatectomy (RARP), and external beam radiation therapy (RT) in the treatment of localized low- and intermediate-risk prostate cancer. Methods: We searched bibliographic databases for case-control, cohort, and randomized controlled studies. We used MeSH subject headings and free text terms for prostate cancer, HIFU, ORP, RARP, RT, failure-free survival (FFS), biochemical disease-free survival (BDFS), urinary incontinence (UI), and erectile dysfunction (ED). Results: Fourteen studies were included in the review, for a total of 34 927 participants. Among the 8 studies of HIFU as the primary treatment of localized low- and intermediate-risk prostate cancer, 4 studies reported 5-year FFS rates ranging from 67.8% to 97.8%, 3 studies reported 5-year BDFS ranging from 58% to 85.4%, 5 studies reported 1-year UI rates ranging from 0% to 6%, and 4 studies reported 1-year ED rates ranging from 11.4% to 38.7%. Furthermore, our search revealed a 5-year FFS benefit favoring ORP compared to RT, a 1-year UI rate favoring ORP compared to RARP, and a 1-year ED rate favoring ORP compared to RARP. Conclusion: Our systematic review and meta-analysis revealed lack of studies with active comparators comparing HIFU to standard of care (ORP, RARP, or RT) in primary treatment of localized low- and intermediate-risk prostate cancer. Open radical prostatectomy has favorable efficacy outcomes compared to RT, while RARP has beneficial functional outcomes compared to ORP, respectively.
- Subjects
CAUSES of death; MEDICAL databases; META-analysis; IMPOTENCE; MEDICAL information storage &; retrieval systems; FUNCTIONAL status; RADICAL prostatectomy; SURGICAL robots; SYSTEMATIC reviews; CASE-control method; PRIMARY health care; TREATMENT effectiveness; RANDOMIZED controlled trials; URINARY incontinence; DESCRIPTIVE statistics; ULTRASONIC therapy; RADIOTHERAPY; PROGRESSION-free survival; MEDLINE; ABLATION techniques; PROSTATE tumors; DISEASE risk factors
- Publication
Urology Research & Practice, 2024, Vol 50, Issue 1, p1
- ISSN
2980-1478
- Publication type
Article
- DOI
10.5152/tud.2024.23123