Prognostic significance of six clinicopathological features for biochemical recurrence after radical prostatectomy: a systematic review and meta-analysis
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Haoran Liu1,2,*, Hui Zhou1,2,*, Libin Yan1,2, Tao Ye1,2, Hongyan Lu1,2, Xifeng Sun1,2, Zhangqun Ye1,2 and Hua Xu1,2
1Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
2Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
*These authors contributed equally to this work
Hua Xu, email: firstname.lastname@example.org
Keywords: clinicopathological features; biochemical recurrence; prostate cancer; radical prostatectomy; meta-analysis
Received: November 30, 2016 Accepted: October 11, 2017 Epub: November 06, 2017 Published: August 14, 2018
Identifying patients with high risk of biochemical recurrence after radical prostatectomy is of immense value in clinical practice. Assessment of prognostic significance of specific clinicopathological features plays an important role in surgical management after prostatectomy. The purpose of our meta-analysis was to investigate the association between the six pathological characteristics and the prognosis of prostate cancer. We carried out a systematic document retrieval in electronic databases to sort out appropriate studies. Outcomes of interest were gathered from studies comparing biochemical recurrence-free survival (BCFS) in patients with the six pathological traits. Studies results were pooled, and hazard ratios (HRs) combined with corresponding 95% confidence intervals (CIs) for survival were used to estimate the effect size. 29 studies (21,683 patients) were enrolled in our meta-analysis. All the six predictors were statistically significant for BCFS with regard to seminal vesicle invasion (HR = 1.97, 95% CI = 1.79–2.18, p < 0.00001), positive surgical margin (HR = 1.79, 95% CI = 1.56–2.06, p < 0.00001), extracapsular extension (HR = 2.03, 95% CI = 1.65–2.50, p < 0.0001), lymphovascular invasion (HR = 1.85, 95% CI = 1.54–2.22, p < 0.00001), lymph node involvement (HR = 1.88, 95% CI = 1.37–2.60, p = 0.0001) and perineural invasion (HR = 1.59, 95% CI = 1.33–1.91, p < 0.00001). Subgroup analysis showed that all the six predictors had significantly relationship with poor BCFS. The pooled results demonstrated that the six clinical findings indicated a worse prognosis in patients with prostate cancer. In conclusion, our results show several clinicopathological characteristics can predict the risk of biochemical recurrence after radical prostatectomy. Prospective studies are needed to further confirm the predictive value of these features for the prognosis of prostate cancer patients after radical prostatectomy.
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