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Table 1 Characteristics of included studies (N = 25)

From: The efficacy and safety of radical prostatectomy and radiotherapy in high-risk prostate cancer: a systematic review and meta-analysis

Study ID/date

Study design

Time

Definition of high-risk PCa

Median age (RP vs RT)

Sample (n)

Comparison of treatments

Median follow-up

End-points

Jayadevappa 2019

R. cohort

1996–2003

GS ≥ 8 or T ≥ T2c

NA

6296

RP vs EBRT vs EBRT + BT

10 years

OS/CSS

Reichard 2019

R. cohort

2004–2013

NCCN

66 vs 61

304

RP vs RT

82.9 months

OS/MFS

Caño-Velasco 2019

R. cohort

1996–2008

EAU

65 vs 71

286

RP vs EBRT

RP: 152 months

RT: 97 months

CSS/OS

Muralidhar 2019

R. cohort

2004–2012

GS: 9–10

NA

4367

2276

RP+aRT vs EBRT+BT

6.0 years (NCDB)

5.8 years (SEER)

OS

Berg 2019

R. cohort

2004–2015

NCCN

58.15 vs 58.12

13985

RP vs EBRT+BT

RP: 91 months

EBRT+BT: 101 months

OS

Tilki 2019

R. cohort

1992–2013

GS: 9–10

MaxRT: 70.34

RP: 66. 40

RP+aRT:66.64 MaxRP: 66.04

RP+ADT: 66.38

639

RP vs RP+aRT vs MaxRP vs RP+ADT

vs MaxRT

MaxRT: 5.51 years

RP: 4.89 years

RP + aRT: 3.87 years

MaxRP: 4.88 years

RP + ADT: 4.65 years

CSS/OS

Jang 2018

R. cohort

1992–2009

T ≥ T3

NA

13856

RP+aRT vs RT

14.6 years

CSS/OS

Tyson 2018

P. cohort

2011–2012

D’Amico

65

2117

RP vs EBRT

3 years

QoL

Ennis 2018

R. cohort

2004–2013

NCCN

RP vs EBRT vs EBRT+BT:

62.61 vs 69.66 vs 67.15

42765

RP vs EBRT vs EBRT+BT

36.34 months

OS

Gu 2018

R. cohort

2004–2008

NCCN

66

7656

RP vs EBRT

NA

CSS/OS

Markovina 2018

R. cohort

2002–2011

NCCN

62.9 vs 64.2

246

RP vs EBRT

RP: 41 months

RT: 51.4 months

OS/MFS

Kishan 2018

R. cohort

2000–2013

GS: 9–10

RP vs EBRT vs EBRT+BT:

61 vs 67.7 vs 67.5

1809

RP vs EBRT vs EBRT+BT

61 vs 67.7 vs 67.5

RP: 4.2 years EBRT: 5.1 years EBRT + BT: 6.3 years

CSS/OS/MFS

Robinson 2018

R. cohort

1998–2012

NCCN

63.1 vs 67

41953

RP vs RT

RP: 7.3 years

RT: 6.9 years

CSS

Feldman 2017

R. cohort

1992–2009

T3

71.76 vs 71.75

2935

RP vs EBRT

RP: 11.47 years

EBRT: 7.04 years

OS/CSS/QoL

Ciezki 2017

P. cohort

1996–2012

NCCN

LDRBT vs EBRT vs RP:

70 vs 68.5 vs 62

2557

LDRBT vs EBRT vs RP

LDRBT: 48.9 months

EBRT: 94.6 months

RP: 55.6 months

BRFS/CSS/QoL

Yamamoto 2015

P. cohort

2006–2010

NCCN

67 vs 71

150

RP vs EBRT

2 years

QoL

Sun 2014

R. cohort

1992–2005

T2c

70 vs 73

67087

RP vs RT vs WW

NA

OS/CSS

Hoffman 2013

R. cohort

1994–1995

PSA > 10 or GS 8–10

NA

1655

RP vs EBRT

15 years

OS/CSS

Kibel 2012

R. cohort

1995–2005

D’Amico

RP vs EBRT vs BT:

60 vs 69 vs 68(Clinic 1)

61 vs 70 vs 69(Clinic 2)

10429

RP vs EBRT vs BT

67 months

OS/CSS

Westover 2012

R. cohort

1988–2009

D’Amico

65 vs 70

657

RP vs EBRT+BT

RP: 7.6 years

EBRT + BT: 3.6 years

CSS

Boorjian 2011

R. cohort

1988–2004

NCCN

RP: 66

EBRT+ADT: 68.8

EBRT: 69.3

1847

RP vs EBRT+ADT vs EBRT

RP: 10.2 years

EBRT + ADT: 6.0 years

EBRT: 7.3 years

OS/CSS

Aizer 2009

R. cohort

1997–2005

MSK/NCCN

NA

556

RP vs EBRT

RP: 46 months

EBRT: 40 months

BRFS

Takizawa 2009

R. cohort

1998–2004

NCCN

64.9 vs 71.1

162

RP vs EBRT

41 months

OS/BRFS/QoL

Arcangeli 2009

R. cohort

2003–2007

NCCN

65.5 vs 75

284

RP vs EBRT

RP: 33.8 months EBRT: 38.6 months

BRFS

Akakura 2006

RCT

1989–1993

T2b-3N0M0

68.1 vs 68.7

95

RP vs EBRT

102 months

BRFS/CSS/OS/QoL

  1. RP prostatectomy, RT radiotherapy, EBRT external beam radiation therapy, BT brachytherapy, ADT androgen deprivation therapy, aRT adjuvant radiotherapy, WW watchful waiting, MaxRP RP + aRT + ADT, MaxRT EBRT + BT + ADT, LDRBT low-dose-rate brachytherapy, PSA prostate-specific antigen, GS Gleason score, NCCN National Comprehensive Cancer Network, MSK Memorial Sloan Kettering, QoL quality of life, OS overall survival, CSS cancer-specific survival, BRFS biochemical recurrence-free survival, MFS metastasis-free survival, CRF clinical recurrence-free survival, R. cohort retrospective cohort, P. cohort prospective cohort, P. and R. cohort prospective and retrospective cohort, RCT randomized controlled trial, vs versus, NA not available