Comparative efficacy and safety of treatments for localised prostate cancer: an application of network meta-analysis
dc.contributor.author | Xiong, T | |
dc.contributor.author | Turner, RM | |
dc.contributor.author | Wei, Yinghui | |
dc.contributor.author | Neal, DE | |
dc.contributor.author | Lyratzopoulos, G | |
dc.contributor.author | Higgins, JPT | |
dc.date.accessioned | 2016-11-19T11:40:31Z | |
dc.date.available | 2016-11-19T11:40:31Z | |
dc.date.issued | 2014-05 | |
dc.identifier.issn | 2044-6055 | |
dc.identifier.issn | 2044-6055 | |
dc.identifier.other | ARTN e004285 | |
dc.identifier.uri | http://hdl.handle.net/10026.1/6765 | |
dc.description.abstract |
CONTEXT: There is ongoing uncertainty about the optimal management of patients with localised prostate cancer. OBJECTIVE: To evaluate the comparative efficacy and safety of different treatments for patients with localised prostate cancer. DESIGN: Systematic review with Bayesian network meta-analysis to estimate comparative ORs, and a score (0-100%) that, for a given outcome, reflects average rank order of superiority of each treatment compared against all others, using the Surface Under the Cumulative RAnking curve (SUCRA) statistic. DATA SOURCES: Electronic searches of MEDLINE without language restriction. STUDY SELECTION: Randomised trials comparing the efficacy and safety of different primary treatments (48 papers from 21 randomised trials included 7350 men). DATA EXTRACTION: 2 reviewers independently extracted data and assessed risk of bias. RESULTS: Comparative efficacy and safety evidence was available for prostatectomy, external beam radiotherapy (different types and regimens), observational management and cryotherapy, but not high-intensity focused ultrasound. There was no evidence of superiority for any of the compared treatments in respect of all-cause mortality after 5 years. Cryotherapy was associated with less gastrointestinal and genitourinary toxicity than radiotherapy (SUCRA: 99% and 77% for gastrointestinal and genitourinary toxicity, respectively). CONCLUSIONS: The limited available evidence suggests that different treatments may be optimal for different efficacy and safety outcomes. These findings highlight the importance of informed patient choice and shared decision-making about treatment modality and acceptable trade-offs between different outcomes. More trial evidence is required to reduce uncertainty. Network meta-analysis may be useful to optimise the power of evidence synthesis studies once data from new randomised controlled studies in this field are published in the future. | |
dc.format.extent | e004285-e004285 | |
dc.format.medium | Electronic | |
dc.language | en | |
dc.language.iso | eng | |
dc.publisher | BMJ | |
dc.subject | Meta-Analysis | |
dc.subject | Prostate Cancer | |
dc.subject | Randomised Trials | |
dc.subject | Systematic Review | |
dc.subject | Treatment | |
dc.subject | Humans | |
dc.subject | Male | |
dc.subject | Prostatic Neoplasms | |
dc.subject | Randomized Controlled Trials as Topic | |
dc.subject | Therapeutics | |
dc.subject | Treatment Outcome | |
dc.title | Comparative efficacy and safety of treatments for localised prostate cancer: an application of network meta-analysis | |
dc.type | journal-article | |
dc.type | Comparative Study | |
dc.type | Journal Article | |
dc.type | Meta-Analysis | |
dc.type | Research Support, Non-U.S. Gov't | |
dc.type | Review | |
dc.type | Systematic Review | |
plymouth.author-url | https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000336976900101&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008 | |
plymouth.issue | 5 | |
plymouth.volume | 4 | |
plymouth.publication-status | Published | |
plymouth.journal | BMJ Open | |
dc.identifier.doi | 10.1136/bmjopen-2013-004285 | |
plymouth.organisational-group | /Plymouth | |
plymouth.organisational-group | /Plymouth/Faculty of Science and Engineering | |
plymouth.organisational-group | /Plymouth/Faculty of Science and Engineering/School of Engineering, Computing and Mathematics | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA/EXTENDED UoA 10 - Mathematical Sciences | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA/UoA10 Mathematical Sciences | |
plymouth.organisational-group | /Plymouth/Users by role | |
plymouth.organisational-group | /Plymouth/Users by role/Academics | |
plymouth.organisational-group | /Plymouth/Users by role/Researchers in ResearchFish submission | |
dc.publisher.place | England | |
dc.identifier.eissn | 2044-6055 | |
dc.rights.embargoperiod | Not known | |
rioxxterms.versionofrecord | 10.1136/bmjopen-2013-004285 | |
rioxxterms.licenseref.uri | http://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.type | Journal Article/Review | |
plymouth.oa-location | http://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC4024605&blobtype=pdf |