Table 4 Results of high-risk group/subgroup 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

Comparison of therapy/Simple size for high-risk group

RT/ADT regimen

Death counts for high-risk group due to PCa

End-points

OS

CSS

CSM

Other end-points

Studies without combined regimens ( N = 6)

       

Zelefsky et al. 2010 [16]

RP vs. EBRT 348 vs. 61

81 Gy or 86.4 Gy

13 vs. 6

NA

NA

RP > RT

AD of 8-y DMFSa: RP > RT

Merino et al. 2013 [17]

RP vs. IMRT 216 vs. 78

76 Gy

27 vs. 18

RP RT§

RP > RT$

RP > RT

 

Tewari et al. 2007 [18]

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

  

NA

NA

RP > RT WW

 

Kibel et al. 2012 [19]

RP vs. EBRT vs. BT 525 vs. 676 vs. 33

median dose: 7,400 cGy

 

RP RT; RP BT

NA

RP RT; RP > BT

 

Stokes et al. 2000 [20]

RP vs. EBRT vs. SI 134 vs. 95 vs. 39

pelvis/periprostatic region: 4500 cGy/6500–7000 cGy

 

NA

NA

NA

5-y BDFSb: RP RT > BT

Cooperberg et al. 2010 [21]

RP vs. EBRT vs. ADT 328 vs. 279 vs. 417

  

NA

NA

NA

D of HR for CSMc: RP > RT > ADT

Studies with combined regimens ( N = 12)

       

Siddiqui et al. 2011 [22]

RP vs. RP+aADT 191 vs.191

  

RP+aADT > RP

RP+aADT RP

NA

 

Bastide et al. 2011 [23]

RP vs. RP+aADT82 vs. 41

ADT: 15 mo

 

NA

NA

NA

HR for PSA-BCRd: RP+aADT > RP

Koie et al. 2014 [24]

RP+nADT vs. RT+nADT 78 vs. 78

RT: 70–76 Gy ADT: 6 mo

 

RP+nADT > RT+nADT

NA

NA

3-y BDFS: RT+nADT > RP+nADT

Lee et al. 2014 [25]

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

RT: 6–10 MV, 74–79 Gy

RP vs.EBRT+(n+a)ADT 12 vs. 23

NA

RP > RT+(n+a)ADT

RP RT+(n+a)ADT

 

Hsu et al. 2006 [26]

RP vs. RT+nADT 200 vs. 35

nADT: varied cross patients

RP vs. RT+nADT 8 vs. 7

RP > RT+nADT

RP > RT+nADT

NA

 

Westover et al. 2012 [27]

RP vs. Combination 285 vs. 372

RT: 45 Gy; ADT: 4.3 mo BT: 125 I or 103 Pd

RP vs. Combination 15 vs. 6

NA

NA

RT+BT+(n+c)ADT>RP

 

Bolla et al. 1997 [12]

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

RT: 70 Gy; ADT: cyproterone acetate, goserelin

RT+aADT vs. RT 6 vs. 26

RT+aADT RT

NA

NA

 

D'Amico et al. 2004 [13]

RT vs. RT+(c+a)ADT& 77 vs. 76

RT:70.35 Gy; ADT: leuprolide acetate/goserelin,6 mo

 

RT+aADT RT

NA

NA

 

Pilepich et al. 1997 [14]

RT vs. RT+aADT 110 vs. 115

RT: 65–70 Gy; ADT: goserelin 3.6mg

RT vs. RT+aADT40 vs. 25

NA

RT+aADT RT

NA

 

Pilepich et al. 2001 [15]

RT vs. RT+(n+c)ADT 67 vs. 57

RT: 65–70 Gy; ADT: Goserelin/Flutamide 3.6mg/250 mg

RT vs. RT+(n+c)ADT 46 vs. 37

RT+(n+c)ADT > RT

NA

RT+(n+c)ADT > RT

 

G 2004 [28]

BT+RT vs. “ADT”e 240 vs. 119

BT: iridium-192, 370 GBq; EBRT:45.6–50 Gy; ADT: 4 mo

“No ADT” vs. “ADT”f 7 vs. 12

“No ADT” > “ADT”

“No ADT” “ADT”

NA

 

Demanes et al. 2009 [29]

BT+RT vs. BT+RT+nADT 48 vs. 65

BT: 5.5–6.0 Gy; RT: 36.0–39.6 Gy ADT: 4.6 mo

 

NA

NA

NA

10-y PSA-PFSg (No-ADT vs. ADT): 62%vs.70%,p>0.05

  1. §AB: A had better survival outcome than B for the corresponding end-point and the difference between A and B was significant.
  2. $A>B: A had better survival outcome than B for the corresponding end-point, but the difference between A and B was non-significant.
  3. &The outcome of OS of the study was applied for the intermediate and high-risk localized PCa; the subgroup analysis for high-risk PCa was not conducted actually.
  4. a. AD of 8-y DMFS: The Absolute Difference (AD) between groups (using RP-RT) for 8-year Distal Metastases-Free Survival.
  5. b. BDFS: Biochemical Disease-Free Survival.
  6. c. The differences of HR for 10-year CSM: 0/2/4/5/6/8/10 point (6–10 points: high-risk): (using RT-RP) 0.62/1.19/2.23/3.03/4.07/6.94/10.41; (ADT-RT) 1.19/2.07/4.22/5.64/7.42/11.81/15.57; (ADT-RP) 1.81/3.54/6.45/8.67/11.49/18.75/25.98.
  7. d. PSA-BCR: Biochemical recurrence of PSA testing.
  8. e. “ADT” means RT+BT+(n+c)ADT.
  9. f. “No ADT” vs. “ADT” = BT+EBRT vs. BT+EBRT+ADT.
  10. g. PSA-progression-free survival. Dates were not available. NA: Not applicable.