首页良性前列腺增生治疗及预后证据详情

Incidence, predictive factors and oncological outcomes of incidental prostate cancer after endoscopic enucleation of the prostate: a systematic review and meta-analysis

原文:2022年 发布于 World J Urol 40卷 第1期 87-101 浏览量:578次 原文链接

作者: Cheng B. K. Castellani D. Chan I. S. Baker A. Gauhar V. Wroclawski M. L. Santamaria H. T. Tanidir Y. Enikeev D. Chan V. W. Ng C. F. Herrmann T. Teoh J. Y.

作者单位: Department of Surgery, United Christian Hospital, Hong Kong, China. bryan.ckc@gmail.com. Department of Urology, University Hospital "Ospedali Riuniti" and Polytechnic University of Marche Region, Ancona, Italy. S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China. Department of Urology, Ng Teng Fong General Hospital, NUHS, Jurong East, Singapore. Hospital Israelita Albert Einstein, Sao Paulo, Brazil. BP-a Beneficencia Portuguesa de Sao Paulo, Sao Paulo, Brazil. Hospital Covadonga, Corporativo De Hospitalea S.A. de C.V., Córdoba, Mexico. Department of Urology, Marmara University School of Medicine, İstanbul, Turkey. Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. Department of Urology, Spital Thurgau AG, Frauenfeld, Switzerland. Department of Urology, Hanover Medical School (MHH), Hanover, Germany. S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China. jeremyteoh@surgery.cuhk.edu.hk.

归属分类: 良性前列腺增生治疗及预后证据

DOI: 10.1007/s00345-021-03756-9

关键词: *Endoscopy Humans Incidence Incidental Findings Male *Prostatectomy/methods Prostatic Hyperplasia Prostatic Neoplasms/diagnosis/*epidemiology

文献简介

INTRODUCTION: This systematic review aims at reporting the incidence, predictive factors, and the oncological outcomes of incidental prostate cancer (IPCa) in men who underwent endoscopic enucleation of prostate (EEP). METHODS: A literature search was performed using the following Medical Subject Heading (MeSH) terms and keywords: "Prostatic Neoplasms", "Prostate Cancer", "Transurethral Resection of Prostate", "Prostate resection", "Prostate enucleation". Meta-analysis was performed if there were two or more studies reporting the same outcome under the same definition. In case of insufficient data, results were presented in a narrative manner. RESULTS: Sixty-one studies were included in qualitative synthesis and 55 were included in meta-analysis. The pooled IPCa rate was 0.08 (95% CI 0.073-0.088). Increasing age, higher preoperative serum prostate-specific antigen (PSA) level, higher preoperative PSA density (PSAD), smaller prostate volume, higher postoperative PSA velocity and lower enucleated prostate weight, were reported to have significant correlation with IPCa. In BPH patients, the mean pre-operative and post-operative PSA levels were 5.58 ± 1.48 ng/dL and 1.06 ± 0.27 ng/dL, respectively. In patients with IPCa, the mean pre-operative and post-operative PSA levels were 7.72 ± 2.90 ng/dL and 2.77 ± 1.66 ng/dL, respectively. The mean percentage PSA reduction was 82.0% ± 1.8% for BPH patients and 68.2% ± 12.1% for IPCa patients. IPCa was most commonly managed by active surveillance (68.7%). CONCLUSIONS: The pooled incidence of IPCa after EEP was 8%. An absolute post-operative PSA level of < 2.0 and a percentage PSA reduction of > 70% should be expected in BPH patients after EEP.

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