Meta-Analysis:
Chemoprevention of prostate cancer in men with high-grade prostatic intraepithelial neoplasia (HGPIN): a systematic review and adjusted indirect treatment comparison
PDF | HTML | Supplementary Files | How to cite
Metrics: PDF 2353 views | HTML 3384 views | ?
Abstract
Kang Cui1,*, Xiangnan Li2,*, Yabing Du1,*, Xiance Tang3, Seiji Arai4,5, Yiwei Geng1, Ying Xi1, Han Xu6, Yue Zhou7, Wang Ma1 and Tengfei Zhang1
1 Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
2 Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
3 Department of Medical Affairs, Henan Cancer Hospital, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, China
4 Department of Hematology and Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
5 Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan
6 Department of Breast Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
7 Deparmtent of B-Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
* These authors have contributed equally to this work
Correspondence to:
Tengfei Zhang, email:
Wang Ma, email:
Keywords: HGPIN, prostate cancer, chemoprevention, adjusted indirect meta-analysis, green tea catechins
Received: February 12, 2017 Accepted: March 06, 2017 Published: March 15, 2017
Abstract
Background: High-grade prostatic intraepithelial neoplasia (HGPIN) is the precursor or premalignant form of prostate cancer. At least 30% patients with a confirmed HGPIN will develop prostate cancer within 1 year after repeated biopsy. HGPIN patients are the appropriate at-risk population for chemoprevention strategies investigation against prostate cancer. However the commonly used chemoprevention agents that targeted on hormonal imbalance or lifestyle-related factors showed varied results in HGPIN patients.
Methods: Literature searches were conducted in PubMed, EMBASE and Cochrane library according to Cochrane guidelines before January 31st, 2017. Direct meta-analysis were performed to summarize the efficacy of candidate chemopreventative agents Dutasteride, Flutamide, Toremifene, Selenium, Green tea components, Lycopene and natural food products combination. Adjusted indirect meta-analyses were employed to compare the relative efficacy of these candidate chemoprevention agents head-to-head.
Results: The overall incidence of prostate cancer in HGPIN was slightly decreased by chemoprevention agents (25.7% vs 31.5%, RR = 0.92, 95% CI: 0.83-1.03, P = 0.183), with minor heterogeneity (I2 = 22.3%, 𝟀2 = 15.08, P = 0.237), but without statistical significance. Subgroup analysis showed that green tea catechins significantly decreased prostate cancer in HGPIN patients (7.60% vs 23.1%, RR = 0.39, 95% CI: 0.16-10.97, P P = 0.044), with moderate heterogeneity (I2 = 47.9%, 𝟀2 = 1.92, P = 0.166). The adjusted indirect meta-analysis favored green tea catechins over other chemoprevention agents, and significantly when compared to natural food products combination (RR = 0.355, 95% CI: 0.134-0.934).
Conclusion: The overall efficacy of chemoprevention agents in HGPIN patients is limited. But Green tea catechins showed the superiority to decrease prostate cancer in HGPIN patients.
All site content, except where otherwise noted, is licensed under a Creative Commons Attribution 4.0 License.
PII: 16230