Evidence map›Paper›PMID 40719409›Full record

SynthesisThe Prostate2025

Efficacy of Treatments for T3bN0M0 Prostate Cancer Patients: A Systematic Review and Meta-Analysis.

Casper Reijnen, Wilma D Heemsbergen, Kimberley E Wever, Aishly Panneflek, Floris J Pos, J P Michiel Sedelaar, Uulke A van der Heide, Luca Incrocci, Robert Jan Smeenk

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in The Prostate, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Casper ReijnenDepartment of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0001-6873-7832
Wilma D HeemsbergenDepartment of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Kimberley E WeverDepartment of Anaesthesiology, Pain and Palliative Medicine, Radboud University medical center, Nijmegen, The Netherlands.
Aishly PanneflekDepartment of Biology, Radboud University, Nijmegen, The Netherlands.
Floris J PosDepartment of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
J P Michiel SedelaarDepartment of Urology, Radboud University Medical Center, Nijmegen, The Netherlands.
Uulke A van der HeideDepartment of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Luca IncrocciDepartment of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Robert Jan SmeenkDepartment of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.

Funding

The authors received no specific funding for this work.
6 · The paper itself

Abstract

backgroundPatients with prostate cancer (PC) invading into the seminal vesicles (SV) constitute a specific subgroup of high-risk patients (staged as T3b) with a particularly high risk of disease recurrence, even when lymph node or distant metastases are absent (N0M0). The aim of the current systematic review and meta-analysis was to investigate efficacy of available treatments for men with PC invading the SV without metastasis.

methodsA systematic review was performed according to the Cochrane guidance and reported according to the guidelines for the Preferred Reporting Items for Systematic Reviews and Meta-analyses. The review protocol was registered prospectively in the PROSPERO database. Studies identified in MEDLINE, EMBASE, and trial registries were selected by two independent reviewers. Treatment modalities included radical prostatectomy with pelvic lymphadenectomy; external beam radiotherapy (EBRT), high-dose rate or low-dose rate brachytherapy, androgen deprivation therapy (ADT), or a combination of treatments. Primary outcome measure was 5-year biochemical recurrence free survival (BRFS).

resultsTwenty-five studies, comprising 2 881 patients, were included. For EBRT and ADT pooled estimated 5-year BRFS was 68%, varying from 56% in studies on low-dose radiotherapy (< 74 Gray [Gy]), up to 78% in studies on high-dose radiotherapy (≥ 74 Gy). For EBRT with brachytherapy and ADT pooled estimated 5-year BRFS was 83%. For radical prostatectomy pooled estimated 5-year BRFS was 32%. When combining surgery with adjuvant treatment (EBRT or ADT) pooled estimated 5-year BRFS was 54% and 63%, respectively.

conclusionsThese results indicate a role for high-dose radiotherapy (≥ 74 Gy) and long-term ADT in T3bN0 PC rather than primary surgical treatment. In addition to dose-escalated radiotherapy to the entire prostate gland (≥ 74 Gy), selected patients should be offered focal dose-escalation to the tumor, by high-dose rate brachytherapy. If proven safe for this patient group, focal dose-escalation could also be offered with EBRT.

Indexed as

Prostatic NeoplasmsAndrogen AntagonistsBrachytherapyCombined Modality TherapyHumansLymph Node ExcisionMaleNeoplasm Recurrence, LocalNeoplasm StagingProstatectomySeminal VesiclesTreatment OutcomeAndrogen Antagonistsprostate cancerradiotherapyseminal vesiclessurgerysystematic reviewtherapy

Identifiers

PMID40719409
PMCPMC12452811

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.