The benefit of radical prostatectomy in patients with lymph node-positive prostate cancer: a systematic review and Meta-analysis

Objective To evaluate the benefit of radical prostatectomy (RP) in patients with lymph node-positive prostate cancer. Methods A systematic review of the studies about radical prostatectomy for the prognosis of node-positive prostate cancer was performed. An electronic search was completed on the basis of PubMed, Embase, Cochrane library, China Biology Medicine disc(CBM), China National Knowledge Infrastructure (CNKI), VIP and Wanfang database from inception up to November 2018. The outcomes are overall survival (OS) and cancer-specific survival(CSS). Results Six studies incorporating 7 890 patients were eligible for the present meta-analysis. 6 247 patients underwent RP, the remaining 1 643 patients did not undergo RP. Lymph node-positive patients treated with RP had improved OS (HR=0.55, 95%CI 0.49-0.62, P<0.001) and CSS (HR=0.49, 95%CI 0.42-0.57, P<0.001). Conclusions Radical prostatectomy may be a beneficial option for patients with lymph node metastases at initial diagnosis, which also improve the OS and CSS. More randomized controlled trials are needed to give more evidence further. Key words: Prostatic neoplasms; Lymph node-positive; Radical prostatectomy; Meta analysis