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Prognostic value of alkaline phosphatase in hormone-sensitive prostate cancer: a systematic review and meta-analysis.
International Journal of Clinical Oncology ( IF 3.3 ) Pub Date : 2019-11-25 , DOI: 10.1007/s10147-019-01578-9
Keiichiro Mori 1, 2 , Florian Janisch 1, 3 , Mehdi Kardoust Parizi 1, 4 , Hadi Mostafaei 1, 5 , Ivan Lysenko 1 , Dmitry V Enikeev 6 , Shoji Kimura 1, 2 , Shin Egawa 2 , Shahrokh F Shariat 1, 6, 7, 8, 9, 10
Affiliation  

PURPOSE To assess the prognostic value of alkaline phosphatase in patients with hormone-sensitive prostate cancer. METHODS A systematic review and meta-analysis was performed using the PUBMED, Web of Science, Cochrane Library, and Scopus in April 2019 according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Studies were deemed eligible if they compared hormone-sensitive prostate cancer patients with high vs. low alkaline phosphatase to determine its predictive value for overall survival, cancer-specific survival, and progression-free survival. We performed a formal meta-analysis of these outcomes. RESULTS 42 articles with 7938 patients were included in the systematic review and 28 studies with 5849 patients for the qualitative assessment. High alkaline phosphatase was associated with worse overall survival (pooled HR 1.72; 95% CI 1.37-2.14) and progression-free survival (pooled HR 1.30; 95% CI 1.10-1.54). In subgroup analyses of patients with "high-volume" and "low-volume", alkaline phosphatase was associated with the overall survival (pooled HR 1.41; 95% CI 1.21-1.64 and pooled HR 1.64; 95% CI, 1.06-2.52, respectively). CONCLUSIONS In this meta-analysis, elevated serum levels of alkaline phosphatase were associated with an increased risk of overall mortality and disease progression in patients with hormone-sensitive prostate cancer. In contrast, those were not associated with an increased risk of cancer-specific mortality. Alkaline phosphatase was independently associated with overall survival in both patients with "high-volume" and "low-volume" hormone-sensitive prostate cancer. Alkaline phosphatase may be useful for being integrated into prognostic tools that help guide treatment strategy, thereby facilitating the shared decision making process.

中文翻译:

碱性磷酸酶在激素敏感性前列腺癌中的预后价值:系统评价和荟萃分析。

目的评估碱性磷酸酶在激素敏感性前列腺癌患者中的预后价值。方法根据系统评价和荟萃分析的首选报告项目,于2019年4月使用PUBMED,Web of Science,Cochrane图书馆和Scopus进行了系统综述和荟萃分析。如果研究比较了激素敏感性前列腺癌患者与高碱性磷酸酶与低碱性磷酸酶的比较,以确定其对总生存期,癌症特异性生存期和无进展生存期的预测价值,则认为该研究合格。我们对这些结果进行了正式的荟萃分析。结果系统评价包括42篇文章和7938例患者,以及28项研究的5849例患者的定性评估。高碱性磷酸酶与较差的总体生存率(合并HR 1.72; 95%CI 1.37-2.14)和无进展生存期(合并HR 1.30; 95%CI 1.10-1.54)相关。在“高容量”和“低容量”患者的亚组分析中,碱性磷酸酶与总体生存率相关(合并HR 1.41; 95%CI 1.21-1.64和合并HR 1.64; 95%CI 1.06-2.52,分别)。结论在这项荟萃分析中,激素敏感性前列腺癌患者血清碱性磷酸酶水平升高与总死亡率和疾病进展风险增加有关。相反,这些与癌症特异性死亡风险增加无关。碱性磷酸酶与“高容量”和“高容量”患者的总生存率均独立相关。
更新日期:2020-01-30
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