The Efficacy Of Radical Prostatectomy Combined With Pelvic Lymph Node Dissection Or Not:a Meta-analysis

Objective: To evaluate The efficacy of radical prostatectomy combined with pelvic lymph node dissection or not in order to provide evidence for clinical decision-making.Methods: Application of computer to search a number of comprehensive medical literature databases including: Pub Med,MEDLINE,EMBAS,Cochrane,OVID,Web of Science,BIOSIS,CNKI,Wanfang database.The search time is from January 1,1999 to January 1,2019.The literature was selected according to the inclusion and exclusion criteria of the study,and read the literature and collect data.Meta-analysis was performed using the systematic evaluation software Rew-Man5.3 provided by Cochrane Collaboration.Rsults: A total of 21 studies were included.There are 13 articles related to oncology results.A total of 127,839 patients with radical prostatectomy were included,including 78,841 in the experimental group and 48,998 in the control group.There are 9 articles related to non-oncology results.A total of 4989 patients with radical prostatectomy were included,including 2,526 in the experimental group and 2,463 in the control group.Meta-analysis showed that there was no significant difference in BFFS between the pelvic lymph node dissection group and the RP group(HR: 0.91,95% CI:0.80-1.03,P=0.13>0.05).There was no significant difference between postoperative CSS and simple RP group(HR: 1.04,95% CI 0.7-1.54,P=0.86>0.05).The operation time was longer than that of the RP group alone(WMD: 29.34,95% CI:26.73-3.97,P < 0.05).The incidence of postoperative lymphatic leakage was higher than that of the RP group alone(OR: 10.61,95% CI:4.57-24.67,P < 0.05).Conclusion: Patients with radical prostatectomy combined with pelvic lymph node dissection can not improve postoperative oncology results(biochemical failure rate,cancer-specific survival rate,etc.),and pelvic lymph node dissection will prolong the operation time and increase the incidence of lymphatic leakage.