Table 1 Characteristics of included studies (N = 18)

From: Systematic Review and Meta-analysis of the Survival Outcomes of First-line Treatment Options in High-risk Prostate Cancer

Study ID

study design

Sites/Time

Population/Median age(RP vs. RT or Alone vs. combination)

Median follow-up

Comparison of treatment/N

End-points

Definition of high-risk PCa

Studies without combined regimens ( N = 6)

       

Zelefsky et al. 2010 [16]

R. cohort

New York, US 1993-2002

Clinical stages T1c-T3b/60(55–65) vs. 69(64–73)

RP: 5 yr EBRT: 5.1 yr

RP vs. EBRT 1318 vs. 1062

CSM, DMFS

T3, Gleason 8–10, or PSA>20ng/ml

Merino et al. 2013 [17]

R. cohort

Chile 1990–2010

Localized PCa/63 (62.6–63.5) vs. 70(69–71)

RP: 91.7 mo IMRT: 76 mo

RP vs. IMRT 993 vs. 207

OS, CSS, BDFS

D'Amico definition

Tewari et al. 2007 [18]

R. cohort

New York, US 1980–1997

High-risk localized PCa 62.9 ± 6.2 vs. 68.1 ± 5.8

RP vs. EBRT vs. WW 68 vs. 53 vs. 52 mo

RP vs. EBRT vs. WW 119 vs. 137 vs. 197

OS,CSS

Poorly differentiated, Gleason 8–10

Kibel et al. 2012 [19]

P. and R. cohort

Missouri/Ohio, US 1995–2005

Localized PCa 60(56–65) vs. 69(63–73)

67 mo

RP vs. EBRT vs. BT 6485vs. 2264 vs.1680

OS, CSM

D'Amico definition

Stokes et al. 2000 [20]

R. cohort

Alabama, US 1988–2000

Localized PCa 66(43–79) vs. 72(49–87)

RP vs. EBRT vs. SI 66 vs. 72 vs.74 mo

RP vs. EBRT vs. SI 222 vs. 132 vs. 186

BDFS

T2c, T3, Gleason 7–10, or PSA>20 ng/ml

Cooperberg et al. 2010 [21]

P. and R. cohort

40 community-based centers, US 1995–2008

Localized PCa 62(56–67) vs. 72(67–75)

NA

RP vs. EBRT vs. ADT 5066 vs. 1143 vs. 1329

CSM, ACM

CAPRA Score 6~10

Studies with combined regimens( N = 12)

       

Siddiqui et al. 2011 [22]

Case-controlled study

Rochester, US 1987–2010

Localized T3b PCa/66(48–78) vs. 65(48–79)

10 yr

RP vs. RP+aADT 191 vs.191

OS, CSS

No

Bastide et al. 2011 [23]

R. cohort

Aixen, France 1994–2008

Localized T3b PCa/65.3 vs. 63.7

60.3 mo

RP vs. RP+aADT 82 vs. 41

BCR

No

Koie et al. 2014 [24]

R. cohort

Hirosaki, Japan 2004–2012

High-risk localized PCa/71 vs. 73.5

RP+nADTvs.RT+nADT 37.6 vs.31.5 mo

RP+nADT vs. RT+nADT 216 vs. 81

OS, BRFS

T2c/T3, Gleason 8–10,PSA>20 ng/ml

Lee et al. 2014 [25]

R. cohort

Seoul, Korea 1990–2009

High-risk localized PCa/67.5 ± 7.0 vs. 68.6 ± 8.4

76 mo

RP vs. EBRT+(n+a)ADT 251 vs. 125

CSM

NCCN definition

Hsu et al. 2006 [26]

R. cohort

Leuven, Belgium 1987–2004

Unilateral cT3 PCa/63.3(41–79) vs.65.1(51–75)

74.7 mo

RP vs. RT+nADT 200 vs. 35

OS, CSS

No

Westover et al. 2012 [27]

R. cohort

Boston/Durham, US 1988–2009

Localized PCa and Gleason 8–10/65(58–69) vs.70(66–73)

4.62 yr

RP vs. RT+BT+(n+c)ADT 285 vs. 372

CSM

D'Amico definition

Bolla et al. 1997 [12]

RCT

France, Netherlands, Switzerland1987–1995

High-grade localized and locally advanced PCa/70(51–80) vs. 71(54–80)

45 mo

RT vs. RT+(c+a)ADT 198 vs. 203

OS

No

D'Amico et al. 2004 [13]

RCT

Harvard outreach, US 1995–2001

Intermediate and high-risk localized PCa/73(51–81) vs. 72(49–82)

4.52 yr

CRT vs. CRT+(c+a)ADT 104 vs. 102

Time to PSA failure, OS

Gleason 7–10, PSA>20 ng/ml

Pilepich et al. 1997 [14]

RCT

Scranton/Wisconsin,US, 1987–1992

PCa with cT3 or regional node involved/

4.5 yr

RT vs. RT+aADT 468 vs. 477

CSS

Gleason 8–10

Pilepich et al. 2001 [15]

RCT

California/Sacramento, US, 1987–1991

Bulky PCa (T2–T4) with/without pelvic node involvement/

6.7 yr

RT vs. RT+(n+c)ADT 230 vs. 226

OS, CSM

Gleason 8–10

Galalae et al. 2004 [28]

P. cohort

Germany; US 1986–2000

Localized PCa/

5 yr

HDR-BT+ EBRT vs. HDR-BT +EBRT + (n+c)ADT: 434 vs. 177

OS,CSS

NCCN definition

Demanes et al. 2009 [29]

P. cohort

Oakland, CA1991–2008

Localized PCa/

6.4 yr

BT+EBRT vs. BT+EBRT+nADT 211 vs. 200

OS, BC

NCCN definition

  1. P. and R. Cohort: prospective and retrospective cohort study. RCT: randomized controlled trial. EBRT: external beam radiotherapy. CRT: 3-dimensional conformal radiation therapy. ADT: androgen-deprivation therapy. nADT: neoadjuvant ADT. (n+a)ADT: neoadjuvant and adjuvant ADT. (n+c)ADT: neoadjuvant and concurrent ADT. IMRT: intensity-modulated radiation therapy. BT: brachytherapy. HDR-BT: High Dose Rate BT represented one form of BT. SI: Seed implantation represented the other form of BT. WW: watchful waiting. OS: Overall Survival. CSS: Cancer-Specific Survival. CSM: Cancer-Specific Mortality. ACM: All-Cause Mortality (To assess perioperative mortality and death from complicationsof radiation). DMFS: Distant Metastases-Free Survival. BDFS: Biochemical Disease-Free Survival. BRFS: biochemical recurrence-free survival. BC: Biochemical control of PSA testing. BCR: Biochemical recurrence of PSA testing. D'Amico definition: PSA >20ng/ml, Gleason score 8–10, or clinical stage ≥ T2c. NCCN definition: PSA >20ng/ml, Gleason score 8–10, or clinical stage ≥T3a. CAPRA Score: Ranging from 0–10, mainly based on PSA levels, biopsy Gleason grade, clinical T stage, age at diagnosis and percentage of positive biopsy cores; a score of 6–10 points was considered to be high-risk. Dates were not available. NA: not applicable.