A structured literature review of treatment for localized prostate cancer. Prostate Disease Patient Outcome Research Team.

摘要: OBJECTIVE We performed a structured literature review to define the clinical course of localized prostate cancer, effectiveness radical surgery and radiation therapy, treatment complications. ARTICLE SELECTION identified more than 1600 English-language, MEDLINE referenced articles for 1966 through 1991. All but 144 were excluded because they lacked primary data, involved fewer 15 patients, or described neither disease nor DATA SYNTHESIS In these articles, persistent genitourinary complications common after external-beam radiation. Radiation resulted in higher incidence bowel problems. The median annual risks development distant metastases cancer-related death 2.6% 1.0%, respectively. Because tumor grade was correlated with (Spearman correlation r = .56) cancer mortality (r .31), controlling necessary before we could compare treatments outcomes. However, stratification by malignancy available only nine patient series describing metastatic rates seven mortality. Furthermore, that rates, 48% neglected identify patients unavailable follow-up, 92% did not stratify age, stratified extent at treatment. CONCLUSIONS Although able treatments, unable determine methodologic inadequacies reviewed. Until better scientific evidence is available, their physicians cannot make informed choices based on knowledge benefits prostatectomy, radiation, watchful waiting.