Cryosurgery would be An Effective Option for Clinically Localized Prostate Cancer: A Meta-analysis and Systematic Review.
Cryosurgery would be An Effective Option for Clinically Localized Prostate Cancer: A Meta-analysis and Systematic Review.
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冷冻手术将是临床局限性前列腺癌的有效选择：荟萃分析和系统评价。
DOI：
10.1038/srep27490
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发表时间：
2016-06-07
影响因子：
4.6
通讯作者：
Yuan J
中科院分区：
文献类型：
--
作者：
Gao L;Yang L;Qian S;Tang Z;Qin F;Wei Q;Han P;Yuan J
冷冻手术（CS）已用于临床局限性PCa患者超过10年。然而，评估其有效性和安全性的临床研究报告了相互矛盾的结果。进行这项系统性评估是为了获得关于CS分别与放疗（RT）和根治性直肠癌切除术（RP）相比的潜在获益和安全性的综合证据。通过PubMed、科克伦图书馆和Embase的综合检索，识别了所有比较CS与RT或RP的对照试验和报告CS治疗结果的单组研究。荟萃分析纳入了来自7项试验的10篇出版物，共1252例患者，显示CS与RT和CS与RP的总生存期和疾病特异性生存期比较无显著差异。然而，CS的无病生存率显著低于RP。此外，对文献的系统性综述集中于数据库的比较数据和单组试验的材料，显示原发性和补救性CS的生存结果均令人满意。我们的研究结果显示冷冻手术是治疗临床局限性前列腺癌的一种相对有效的方法，其生存结果与放疗和根治性前列腺切除术相当。然而，应仔细监测冷冻手术引起的大部分并发症。
Cryosurgery (CS) has been used on patients with clinically localized PCa for more than 10 years. However, clinical studies evaluating its effectiveness and safety have reported conflicting results. This systematic assessment was performed to obtain comprehensive evidence regarding the potential benefits and safety of CS compared with those of radiotherapy (RT) and radical prostatectomy (RP), respectively. All controlled trials comparing CS with RT or RP and single-arm studies reporting results of CS therapy were identified through comprehensive searches of PubMed, the Cochrane Library and Embase. Ten publications from seven trials, with totally 1252 patients, were included in the meta-analysis, which revealed no significant differences in comparisons of CS vs RT and CS vs RP for overall survival and disease specific survival. However, a significantly lower disease-free survival could be observed for CS than RP. Moreover, a systematic review of literature focusing on comparative data of databases and materials of single-arm trials revealed satisfactory survival results in both primary and salvage CS. Our results showed that cryosurgery would be a relatively effective method for clinically localized prostate cancer with survival results comparable to radiotherapy and radical prostatectomy. However, the large percentage of complications caused by cryosurgery should be carefully monitored.