The impact of perioperative blood transfusion on survival and recurrence after radical prostatectomy for prostate cancer: A systematic review and meta-analysis

150 Background: Nearly 50% of men diagnosed with prostate cancer may receive treatment with some form of androgen deprivation therapy (ADT). While some side effects of ADT are well acknowledged, the specific impact of ADT on cognitive function is uncertain. Our objective was to perform a systematic review and meta-analysis assessing the impact of ADT on overall cognitive decline, and the risks of Alzheimers, Parkinson’s disease. Methods: Relevant studies were identified through search of English language articles indexed in PubMed Medline, PsycINFO, Cochrane Library and Web of Knowledge/Science. First, we assessed rates of cognitive decline in five cohorts from three studies. Second, we assessed rates of Alzheimer’s or Parkinson disease using three large retrospective studies. A pooled-analysis was conducted using a meta-analysis. Weighted averages were reported as odds ratios (OR) with 95% confidence intervals (CI) using RevMan and a DerSimonian and Laird random-effects model. The heterogeneity test was measured using the Q-Mantel-Haenszel ( P< 0.10 was considered of significant heterogeneity). Results: With respect to overall cognitive decline (defined as scoring 1.5 standard deviations [SD] in two or more objective cognitive tests), patients receiving ADT had higher odds of overall cognitive decline than patients with prostate cancer not treated with ADT or health controls (OR: 2.03, 95% CI: 1.42–2.90). Furthermore, men with a history of ADT for prostate cancer had higher odds of developing Alzheimer’s and Parkinson dementia compared to men with prostate cancer not treated with ADT (OR: 1.32, 95% CI: 1.27–1.37). Conclusions: Men receiving ADT for prostate cancer performed significantly worse on measures of overall cognitive function. Additionally, results from the three large observational trials included suggest men exposed to ADT for prostate cancer have higher rates of Parkinson/Alzheimer’s compared to men without ADT.

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Statins and prostate cancer recurrence following radical prostatectomy or radiotherapy: a systematic review and meta-analysis

Annals of Oncology ◽

10.1093/annonc/mdt077 ◽

2013 ◽

Vol 24 (6) ◽

pp. 1427-1434 ◽

Cited By ~ 49

Author(s):

H.S. Park ◽

J.D. Schoenfeld ◽

R.B. Mailhot ◽

M. Shive ◽

R.I. Hartman ◽

...

Keyword(s):

Prostate Cancer ◽

Systematic Review ◽

Radical Prostatectomy ◽

Meta Analysis ◽

Cancer Recurrence ◽

Prostate Cancer Recurrence

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MP16-20 OUTCOMES OF RADICAL PROSTATECTOMY FOR LOCALIZED PROSTATE CANCER IN AFRICAN AMERICAN PATIENTS: SYSTEMATIC REVIEW AND META-ANALYSIS OF CONTEMPORARY LITERATURE

The Journal of Urology ◽

10.1016/j.juro.2018.02.554 ◽

2018 ◽

Vol 199 (4S) ◽

Author(s):

Wilson Lin ◽

Kara Watts ◽

Ahmed Aboumohamed

Keyword(s):

Prostate Cancer ◽

Systematic Review ◽

African American ◽

Radical Prostatectomy ◽

Meta Analysis ◽

Contemporary Literature ◽

Localized Prostate Cancer

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Adjuvant radiotherapy following radical prostatectomy for prostate cancer: A systematic review and meta-analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.6_suppl.366 ◽

2020 ◽

Vol 38 (6_suppl) ◽

pp. 366-366

Author(s):

Tobias Engel Ayer Botrel ◽

Otávio Clark ◽

Francisco Flávio Horta Bretas ◽

Marcus V. Sadi ◽

Ubirajara Ferreira ◽

...

Keyword(s):

Prostate Cancer ◽

Systematic Review ◽

Radical Prostatectomy ◽

Adjuvant Radiotherapy ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Expectant Management ◽

Significant Heterogeneity ◽

Free Survival

366 Background: To perform a systematic review and meta-analysis of all randomized controlled trials (RCTs) comparing efficacy of adjuvant radiotherapy (AR) versus expectant management (EM) in men who undergo radical prostatectomy for localized prostate cancer (CaP). Methods: To perform this review and meta-analysis,several databases were searched, including MEDLINE, EMBASE, LILACS, and CENTRAL. We included all the studies that compared AR versus EM after radical surgery for CaP. The primary endpoints analyzed were biochemical progression-free survival (bPFS), metastasis-free survival (MPFS), prostate cancer-specific survival (CSS), overall survival (OS) and side effects. The data extracted from the studies were combined by using the Hazard Ratio (HR) or Risk Ratio (RR) with their corresponding Confidence Intervals of 95% (CI95%). Results: Overall, 68 studies were identified and screened. The final analysis included 7 trials (EORTC 22911, SWOG 8794, ARO 96-02/AUO AP 09/95, RAVES, FINNISH, GETUG-AFU 17 and RADICALS-RT) comprising 4,221 patients. The bPFS was higher in patients who received AR (fixed effect: HR = 0.58, CI95% = 0.52 to 0.66; p < 0.00001) but with significant heterogeneity (Chi2 = 40.34, df = 6 (P < 0.00001); I2 = 85%). We performed a random-effect model analysis to better explore this heterogeneity: in this analysis, the result remained in favor of AR (random effect: HR = 0.64, CI95% = 0.45 to 0.90; p = 0.01). The MPFS also was higher in patients who received AR (HR = 0.77, CI95% = 0.65 to 0.91; p = 0.002). The CSS and OS were not statistically different in patients with or without adjuvant radiotherapy (HR = 0.79, CI95% = 0.47 to 1.32; p = 0.36 and HR = 0.92, CI95% = 0.77 to 1.11; p = 0.38, respectively). The incidence of adverse events (gastrointestinal and genitourinary) were higher in the AR group. Conclusions: This is the first meta-analysis including the seven available RCTs in the literature (the previous meta-analysis reviewed only three), comparing adjuvant radiotherapy versus expectant management following radical prostatectomy for CaP. Adjuvant radiotherapy statistically increased the bPFS and MPFS, but did not have an impact on the OS or CSS.

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