Meta Analysis Of The Efficacy Of Preoperative Neoadjuvant Chemotherapy Combined With Surgery And Surgery Alone In The Treatment Of High-risk Prostate Cancer

Objective: Through this meta analysis,to analyze whether preoperative neoadjuvant chemotherapy(NCHT)combined with surgery has a better effect on patients with high-risk prostate cancer than surgery alone,so as to provide evidence-based evidence for clinical treatment.Methods: The commonly used medical literature websites at home and abroad systematically search Pub Med,Embase,Webof Science,China knowledge Network database(CNKI),Wanfang data knowledge service platform and VIP and other commonly used Chinese and English databases.The retrieval time is from 2000.01.01 to 2021.01.01.Strictly follow the set inclusion criteria and exclusion criteria for literature search,and then carefully read the literature content to extract data,and finally through the world’s largest evidence-based medicine website Cochrane collaboration network designed system evaluation software Rew-Man5.3 for the final Meta analysis and calculation.Results: A total of 6 articles were included,including preoperative neoadjuvant chemotherapy plus radical prostatectomy group(n = 532)and simple radical prostatectomy group(n = 639).The results were as follows: the positive rate of incisal margin in neoadjuvant chemotherapy+ operation group was significantly lower than that in simple operation group,and the difference was statistically significant(OR=0.35,95%CI(0.26),P 0.47),P < 0.00001).The proportion of patients in neoadjuvant chemotherapy + operation group who could not be detected by PSA was significantly higher than that in the simple RP group,and the difference was statistically significant [OR=4.12,95% CI(1.75,9.66),PSA 0.001],and the 1-year survival rate without biochemical progression(Biochemicalprogression-freerate BPFR)in the neoadjuvant chemotherapy + operation group was significantly higher than that in the simple operation group [OR=3.04,95%CI(1.90 ～ 4.87),P < 0.00001)].Conclusions: For patients with high-risk prostate cancer,preoperative neoadjuvant chemotherapy is superior to patients with anterior radical adenectomy in postoperative pathological margin positive rate,undetectable PSA after RP and 1-year survival rate without biochemical progression,and the difference is statistically significant,but the effect on long-term survival rate is not clear,and the above conclusions still need large samples and long-term follow-up randomized controlled trials to further verify.