The impact of positive surgical margin parameters and pathological stage on biochemical recurrence after radical prostatectomy: A systematic review and meta-analysis
To systematically review and perform a meta-analysis on the predictive value of the primary Gleason grade (PGG) at the positive surgical margin (PSM), length of PSM, number of PSMs, and pathological stage of the primary tumor on biochemical recurrence (BCR) in patients with prostate cancer (PCa) aft...
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| creator | Guo, Hong Zhang, Lei Shao, Yuan An, Kunyang Hu, Caoyang Liang, Xuezhi Wang, Dongwen |
| description | To systematically review and perform a meta-analysis on the predictive value of the primary Gleason grade (PGG) at the positive surgical margin (PSM), length of PSM, number of PSMs, and pathological stage of the primary tumor on biochemical recurrence (BCR) in patients with prostate cancer (PCa) after radical prostatectomy (RP).
A systematic literature search was performed using electronic databases, including PubMed, EMBASE, Cochrane Library, and Web of Science, from January 1, 2005, to October 1, 2023. The protocol was pre-registered in PROSPERO. Subgroup analyses were performed according to the different treatments and study outcomes. Pooled hazard ratios with 95% confidence intervals were extracted from multivariate analyses, and a fixed or random effect model was used to pool the estimates. Subgroup analyses were performed to explore the reasons for the heterogeneity.
Thirty-one studies that included 50,028 patients with PCa were eligible for this meta-analysis. The results showed that, compared to PGG3, PGG4/5 was associated with a significantly increased risk of BCR. Compared with PSM ≤3 mm, PSM ≥3 mm was associated with a significantly increased risk of BCR. Compared with unifocal PSM, multifocal PSM (mF-PSM) was associated with a significantly increased risk of BCR. In addition, pT >2 was associated with a significantly increased risk of BCR compared to pT2. Notably, the findings were found to be reliable based on the sensitivity and subgroup analyses.
PGG at the PSM, length of PSM, number of PSMs, and pathological stage of the primary tumor in patients with PCa were found to be associated with a significantly increased risk of BCR. Thus, patients with these factors should be treated differently in terms of receiving adjunct treatment and more frequent monitoring. Large-scale, well-designed prospective studies with longer follow-up periods are needed to validate the efficacy of these risk factors and their effects on patient responses to adjuvant and salvage therapies and other oncological outcomes. |
| doi_str_mv | 10.1371/journal.pone.0301653 |
| format | Article |
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A systematic literature search was performed using electronic databases, including PubMed, EMBASE, Cochrane Library, and Web of Science, from January 1, 2005, to October 1, 2023. The protocol was pre-registered in PROSPERO. Subgroup analyses were performed according to the different treatments and study outcomes. Pooled hazard ratios with 95% confidence intervals were extracted from multivariate analyses, and a fixed or random effect model was used to pool the estimates. Subgroup analyses were performed to explore the reasons for the heterogeneity.
Thirty-one studies that included 50,028 patients with PCa were eligible for this meta-analysis. The results showed that, compared to PGG3, PGG4/5 was associated with a significantly increased risk of BCR. Compared with PSM ≤3 mm, PSM ≥3 mm was associated with a significantly increased risk of BCR. Compared with unifocal PSM, multifocal PSM (mF-PSM) was associated with a significantly increased risk of BCR. In addition, pT >2 was associated with a significantly increased risk of BCR compared to pT2. Notably, the findings were found to be reliable based on the sensitivity and subgroup analyses.
PGG at the PSM, length of PSM, number of PSMs, and pathological stage of the primary tumor in patients with PCa were found to be associated with a significantly increased risk of BCR. Thus, patients with these factors should be treated differently in terms of receiving adjunct treatment and more frequent monitoring. Large-scale, well-designed prospective studies with longer follow-up periods are needed to validate the efficacy of these risk factors and their effects on patient responses to adjuvant and salvage therapies and other oncological outcomes.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0301653</identifier><identifier>PMID: 38990870</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Case reports ; Cohort analysis ; Confidence intervals ; Diseases ; Heterogeneity ; Humans ; Impact analysis ; Male ; Margins of Excision ; Medical research ; Medicine and Health Sciences ; Medicine, Experimental ; Meta-analysis ; Multivariate analysis ; Neoplasm Grading ; Neoplasm Recurrence, Local - pathology ; Neoplasm Staging ; Performance prediction ; Physical Sciences ; Prostate cancer ; Prostate-Specific Antigen - blood ; Prostate-Specific Antigen - metabolism ; Prostatectomy ; Prostatectomy - methods ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - surgery ; Relapse ; Research and Analysis Methods ; Risk analysis ; Risk factors ; Sensitivity analysis ; Subgroups ; Surgery ; Systematic review ; Tumors</subject><ispartof>PloS one, 2024-07, Vol.19 (7), p.e0301653</ispartof><rights>Copyright: © 2024 Guo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Guo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Guo et al 2024 Guo et al</rights><rights>2024 Guo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c642t-81ff65178b47329210bc5551aebebc14205646b0e57aa7959fa3743ddf4c411a3</cites><orcidid>0009-0005-4032-6384 ; 0000-0002-6805-780X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239040/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239040/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38990870$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guo, Hong</creatorcontrib><creatorcontrib>Zhang, Lei</creatorcontrib><creatorcontrib>Shao, Yuan</creatorcontrib><creatorcontrib>An, Kunyang</creatorcontrib><creatorcontrib>Hu, Caoyang</creatorcontrib><creatorcontrib>Liang, Xuezhi</creatorcontrib><creatorcontrib>Wang, Dongwen</creatorcontrib><title>The impact of positive surgical margin parameters and pathological stage on biochemical recurrence after radical prostatectomy: A systematic review and meta-analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To systematically review and perform a meta-analysis on the predictive value of the primary Gleason grade (PGG) at the positive surgical margin (PSM), length of PSM, number of PSMs, and pathological stage of the primary tumor on biochemical recurrence (BCR) in patients with prostate cancer (PCa) after radical prostatectomy (RP).
A systematic literature search was performed using electronic databases, including PubMed, EMBASE, Cochrane Library, and Web of Science, from January 1, 2005, to October 1, 2023. The protocol was pre-registered in PROSPERO. Subgroup analyses were performed according to the different treatments and study outcomes. Pooled hazard ratios with 95% confidence intervals were extracted from multivariate analyses, and a fixed or random effect model was used to pool the estimates. Subgroup analyses were performed to explore the reasons for the heterogeneity.
Thirty-one studies that included 50,028 patients with PCa were eligible for this meta-analysis. The results showed that, compared to PGG3, PGG4/5 was associated with a significantly increased risk of BCR. Compared with PSM ≤3 mm, PSM ≥3 mm was associated with a significantly increased risk of BCR. Compared with unifocal PSM, multifocal PSM (mF-PSM) was associated with a significantly increased risk of BCR. In addition, pT >2 was associated with a significantly increased risk of BCR compared to pT2. Notably, the findings were found to be reliable based on the sensitivity and subgroup analyses.
PGG at the PSM, length of PSM, number of PSMs, and pathological stage of the primary tumor in patients with PCa were found to be associated with a significantly increased risk of BCR. Thus, patients with these factors should be treated differently in terms of receiving adjunct treatment and more frequent monitoring. Large-scale, well-designed prospective studies with longer follow-up periods are needed to validate the efficacy of these risk factors and their effects on patient responses to adjuvant and salvage therapies and other oncological outcomes.</description><subject>Analysis</subject><subject>Case reports</subject><subject>Cohort analysis</subject><subject>Confidence intervals</subject><subject>Diseases</subject><subject>Heterogeneity</subject><subject>Humans</subject><subject>Impact analysis</subject><subject>Male</subject><subject>Margins of Excision</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Medicine, Experimental</subject><subject>Meta-analysis</subject><subject>Multivariate analysis</subject><subject>Neoplasm Grading</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Staging</subject><subject>Performance prediction</subject><subject>Physical Sciences</subject><subject>Prostate cancer</subject><subject>Prostate-Specific Antigen - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guo, Hong</au><au>Zhang, Lei</au><au>Shao, Yuan</au><au>An, Kunyang</au><au>Hu, Caoyang</au><au>Liang, Xuezhi</au><au>Wang, Dongwen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of positive surgical margin parameters and pathological stage on biochemical recurrence after radical prostatectomy: A systematic review and meta-analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-07-11</date><risdate>2024</risdate><volume>19</volume><issue>7</issue><spage>e0301653</spage><pages>e0301653-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To systematically review and perform a meta-analysis on the predictive value of the primary Gleason grade (PGG) at the positive surgical margin (PSM), length of PSM, number of PSMs, and pathological stage of the primary tumor on biochemical recurrence (BCR) in patients with prostate cancer (PCa) after radical prostatectomy (RP).
A systematic literature search was performed using electronic databases, including PubMed, EMBASE, Cochrane Library, and Web of Science, from January 1, 2005, to October 1, 2023. The protocol was pre-registered in PROSPERO. Subgroup analyses were performed according to the different treatments and study outcomes. Pooled hazard ratios with 95% confidence intervals were extracted from multivariate analyses, and a fixed or random effect model was used to pool the estimates. Subgroup analyses were performed to explore the reasons for the heterogeneity.
Thirty-one studies that included 50,028 patients with PCa were eligible for this meta-analysis. The results showed that, compared to PGG3, PGG4/5 was associated with a significantly increased risk of BCR. Compared with PSM ≤3 mm, PSM ≥3 mm was associated with a significantly increased risk of BCR. Compared with unifocal PSM, multifocal PSM (mF-PSM) was associated with a significantly increased risk of BCR. In addition, pT >2 was associated with a significantly increased risk of BCR compared to pT2. Notably, the findings were found to be reliable based on the sensitivity and subgroup analyses.
PGG at the PSM, length of PSM, number of PSMs, and pathological stage of the primary tumor in patients with PCa were found to be associated with a significantly increased risk of BCR. Thus, patients with these factors should be treated differently in terms of receiving adjunct treatment and more frequent monitoring. Large-scale, well-designed prospective studies with longer follow-up periods are needed to validate the efficacy of these risk factors and their effects on patient responses to adjuvant and salvage therapies and other oncological outcomes.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>38990870</pmid><doi>10.1371/journal.pone.0301653</doi><tpages>e0301653</tpages><orcidid>https://orcid.org/0009-0005-4032-6384</orcidid><orcidid>https://orcid.org/0000-0002-6805-780X</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_3078994029 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Analysis Case reports Cohort analysis Confidence intervals Diseases Heterogeneity Humans Impact analysis Male Margins of Excision Medical research Medicine and Health Sciences Medicine, Experimental Meta-analysis Multivariate analysis Neoplasm Grading Neoplasm Recurrence, Local - pathology Neoplasm Staging Performance prediction Physical Sciences Prostate cancer Prostate-Specific Antigen - blood Prostate-Specific Antigen - metabolism Prostatectomy Prostatectomy - methods Prostatic Neoplasms - pathology Prostatic Neoplasms - surgery Relapse Research and Analysis Methods Risk analysis Risk factors Sensitivity analysis Subgroups Surgery Systematic review Tumors |
| title | The impact of positive surgical margin parameters and pathological stage on biochemical recurrence after radical prostatectomy: A systematic review and meta-analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-21T18%3A35%3A16IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20impact%20of%20positive%20surgical%20margin%20parameters%20and%20pathological%20stage%20on%20biochemical%20recurrence%20after%20radical%20prostatectomy:%20A%20systematic%20review%20and%20meta-analysis&rft.jtitle=PloS%20one&rft.au=Guo,%20Hong&rft.date=2024-07-11&rft.volume=19&rft.issue=7&rft.spage=e0301653&rft.pages=e0301653-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0301653&rft_dat=%3Cgale_plos_%3EA800977175%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3078994029&rft_id=info:pmid/38990870&rft_galeid=A800977175&rft_doaj_id=oai_doaj_org_article_4b50ffc89e274ab0b10e3f5280a2b892&rfr_iscdi=true |