Salvage Radical Prostatectomy after Primary Focal Ablative Therapy: A Systematic Review and Meta-Analysis
Abstract
:Simple Summary
Abstract
1. Introduction
2. Evidence Acquisition
2.1. Search Strategy, Inclusion Criteria and Exclusion Criteria
2.2. Data Extraction and Quality Assessment
2.3. Outcomes Categorization
2.4. Data Analysis
3. Evidence Synthesis
3.1. Literature Search Results
3.2. General Features and Quality
3.3. Primary Focal Therapy Characteristics
3.4. Postoperative Outcomes
3.5. Oncologic Outcomes
3.6. Functional Outcomes
3.7. Discussion and Limitations
3.8. Comparison with Other Studies
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
References
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Author | Confounding Bias | Selection Bias | Measurement Bias | Deviations from Intended Intervention Bias | Missing Data Bias | Outcomes Measurement Bias | Selection of Reported Bias | Overall |
---|---|---|---|---|---|---|---|---|
Herrera-Caceres (2017) [17] | low risk | moderate risk | low risk | low risk | low risk | low risk | low risk | low risk |
Marconi (2019) [18] | low risk | moderate risk | low risk | low risk | moderate risk | low risk | low risk | moderate risk |
Onol (2020) [19] | serious risk | moderate risk | low risk | low risk | moderate risk | low risk | low risk | serious risk |
Pierrard (2019) [20] | moderate risk | moderate risk | low risk | low risk | low risk | low risk | low risk | moderate risk |
Thompson (2020) [21] | moderate risk | moderate risk | low risk | low risk | moderate risk | low risk | low risk | moderate risk |
Linares Espinós (2016) [22] | moderate risk | moderate risk | low risk | low risk | low risk | low risk | low risk | moderate risk |
Nunes-Silva (2017) [23] | low risk | moderate risk | low risk | low risk | low risk | low risk | low risk | moderate risk |
Lebdai (2015) [24] | moderate risk | moderate risk | low risk | low risk | low risk | low risk | low risk | moderate risk |
Ribeiro (2021) [25] | moderate risk | moderate risk | low risk | low risk | low risk | low risk | low risk | moderate risk |
Cathcart (2021) [26] | moderate risk | moderate risk | low risk | low risk | low risk | low risk | low risk | moderate risk |
Spitznagel (2021) [27] | moderate risk | moderate risk | low risk | low risk | low risk | low risk | low risk | moderate risk |
De Groote (2020) [28] | moderate risk | moderate risk | low risk | low risk | low risk | low risk | low risk | moderate risk |
First Author | Study Type | Yr | No of Pts Who Received FT | Age (Yr) | Avg Follow- Up (mo) | Time from Tx to sRP (mo) | % Total Complications | % Total >CG3 | % PSM | % BCR | % Continent | % Potent |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Herrera-Caceres [17] | Retrospective noncomparative | 2020 | 34 | 61 | 52 | 11 | 12% | 12% | 38% | 21% | 91% | 53% |
Marconi [18] | Retrospective noncomparative | 2019 | 82 | 65 | - | 27 | 6% | 1% | 13% | 41% | 83% | 21% |
Onol * [19] | Retrospective comparative | 2020 | 32 | 66 | 29 | 61 | 9% | 3% | 44% | 19% | 78% | 28% |
Pierrard [20] | Retrospective noncomparative | 2019 | 42 | 65 | 23 | 17 | 12% | 2% | 31% | 10% | 64% | 75% |
Thompson [21] | Retrospective noncomparative | 2020 | 45 | 63 | 18 | 30 | 18% | 2% | 44% | 24% | 67% | 0% |
Linares Espinós * [22] | Retrospective comparative | 2016 | 14 | 65 | 62 | 24 | 57% | 21% | 7% | 29% | 56% | 60% |
Nunes-Silva ** [23] | Retrospective comparative | 2017 | 22 | 63 | - | 24 | 14% | 14% | 5% | 32% | 32% | 0% |
Lebdai [24] | Retrospective noncomparative | 2015 | 19 | 64 | 10 | 17 | 32% | 11% | 47% | 0% | 68% | 91% |
Ribeiro * [25] | Retrospective comparative | 2021 | 95 | 65 | 30 | 36 | 5% | 1% | 13% | 32% | 83% | 20% |
Cathcart [26] | Retrospective noncomparative | 2021 | 23 | 63 | - | 25 | 4% | 0% | 35% | 17% | 83% | 64% |
Spitznagel *** [27] | Retrospective comparative | 2021 | 13 | 61 | - | 15 | 46% | 31% | 8% | 0% | 23% | 89% |
De Groote * [28] | Retrospective comparative | 2020 | 61 | 67 | 25 | - | 8% | 2% | 38% | 18% | 39% | 5% |
Value | |
---|---|
Median age at time of sRP (yrs) | 65 (range 61–67) |
Time from primary treatment to sRP (mo) | 24 (range 11–61) |
Median follow up (mo) | 27 (range 10–62) |
Type of FT prior to sRP (n = 482) | |
HIFU | 295 (61.2%) |
Cryotherapy | 79 (16.4%) |
VTP | 69 (14.3%) |
Irreversible electroporation | 17 (3.5%) |
Laser | 15 (3.1%) |
PRX302 Topsalysin | 4 (0.8%) |
Brachytherapy | 3 (0.6%) |
Repeat ablation (n = 248) | |
YES | 37 (14.9%) |
NO | 211 (85.1%) |
SRP type (n = 468) | |
Robotic | 399 (85.3%) |
Open | 60 (12.8%) |
Laparoscopic | 9 (1.9%) |
Nerve-sparing (n = 468) | |
Unilateral | 145 (30.9%) |
Bilateral | 115 (24.6%) |
None | 208 (44.5%) |
Pre-Preoperative sRP Biopsy (n = 482) * | |
Grade Group I (3 + 3) | 84 (17.4%) |
Grade Group II (3 + 4) | 216 (44.8%) |
Grade Group III (4 + 3) | 119 (24.7%) |
Grade Group IV (4 + 4) | 21 (4.4%) |
Grade Group V (4 + 5, 5 + 4) | 17 (3.5%) |
Missing | 9 (1.9%) |
Postoperative outcomes | |
Total number of complications (n = 482) | 59 (12.2%) |
Clavien grade I | 24 (40.7%) |
Clavien grade II | 13 (22.0%) |
Clavien grade IIIa | 7 (11.9%) |
Clavien grade IIIb | 14 (23.7%) |
Clavien grade IV | 1 (1.7%) |
Clavien grade V | 0 (0%) |
Major complications (CG >3) (n = 482) | 18 (30.5%) |
Oncologic outcomes (n = 482) | |
Positive surgical margin | 126 (26.1%) |
Biochemical recurrence | 118 (24.5%) |
Postoperative sRP Biopsy (n = 482) * | |
Grade Group I (3 + 3) | 40 (8.3%) |
Grade Group II (3 + 4) | 215 (44.6%) |
Grade Group III (4 + 3) | 134 (27.8%) |
Grade Group IV (4 + 4) | 15 (3.1%) |
Grade Group V (4 + 5, 5 + 4) | 27 (5.6%) |
Missing | 1 (0.2%) |
Functional outcomes | |
Continence (12 mo) (n = 467) | 319 (68.3%) |
Potency (12 mo) (n = 351) | 107 (30.5%) |
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Blank, F.; Meyer, M.; Wang, H.; Abbas, H.; Tayebi, S.; Hsu, W.-W.; Sidana, A. Salvage Radical Prostatectomy after Primary Focal Ablative Therapy: A Systematic Review and Meta-Analysis. Cancers 2023, 15, 2727. https://doi.org/10.3390/cancers15102727
Blank F, Meyer M, Wang H, Abbas H, Tayebi S, Hsu W-W, Sidana A. Salvage Radical Prostatectomy after Primary Focal Ablative Therapy: A Systematic Review and Meta-Analysis. Cancers. 2023; 15(10):2727. https://doi.org/10.3390/cancers15102727
Chicago/Turabian StyleBlank, Fernando, Meredith Meyer, Hannah Wang, Hasan Abbas, Shima Tayebi, Wei-Wen Hsu, and Abhinav Sidana. 2023. "Salvage Radical Prostatectomy after Primary Focal Ablative Therapy: A Systematic Review and Meta-Analysis" Cancers 15, no. 10: 2727. https://doi.org/10.3390/cancers15102727