Chinese Journal of Tissue Engineering Research ›› 2010, Vol. 14 ›› Issue (11): 1931-1934.doi: 10.3969/j.issn.1673-8225.2010.11.008

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Role of preoperative hormone therapy in localised prostate cancer: Meta-analysis based on six randomized controlled trials

Li Tao1,2, Yang Ke-hu1,2, Tian Jin-hui2, Chen Yi-rong3, Li Chao-bin4, Guo Bai-hong3, Li Guo-ping3, Guo Qing-hua5   

  1. 1First Clinical College of Lanzhou University, Lanzhou 730000, Gansu Province, China;
    2Evidence Based Medicine Center of Lanzhou University, Lanzhou  730000, Gansu Province, China;
    3Department of Urinary Surgery, People’s Hospital of Gansu Province, Lanzhou   730000, Gansu Province, China;
    4Department of Andrology, Baoji Maternal and Child Health Hospital, Baoji   721000, Shaanxi Province, China;
    5Department of Andrology, First Hospital of Lanzhou University, Lanzhou  730000, Gansu Province, China
  • Online:2010-03-12 Published:2010-03-12
  • Contact: Chen Yi-rong, Chief physician, Doctoral supervisor, Department of Urinary Surgery, People’s Hospital of Gansu Province, Lanzhou 730000, Gansu Province, China cyirong@yahoo.com
  • About author:Li Tao, Studying for master’s degree, First Clinical College of Lanzhou University, Lanzhou 730000, Gansu Province, China

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Abstract:

BACKGROUND: Previous research has demonstrated that preoperative hormone therapy relieved clinical and pathological stages of prostatic carcinoma patients, reduced positive ratio of incisal margin; however, it did not increase disease-free survival 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 biomedical 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 localised 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 statistical analysis. Overall survival rate, disease-free survival rate, positive surgical margin rate, positive lymph node rate, and seminal vesicle invasion rate were evaluated.
RESULTS AND CONCLUSION: Six randomized controlled trials totaling 1 027 participants were included. The result of meta analysis showed that there was no significant difference in overall survival rate [RR=0.94, 95%CI (0.86, 1.02)], disease-free survival rate [RR=1.02, 95%CI (0.89, 1.17)], positive lymph node rate [RR=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 seminal vesicle invasion rate; however, there was a significant reduction in the positive surgical margin rate.

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