Abstract: Objective To compare the effects of regional anesthesia and general anesthesia on the relapse of prostate cancer patients after surgery through Meta analysis. Methods PubMed, Cochrane Library, Ovidsp and ISI Web of knowledge were retrieved for randomized controlled trial (RCT) or observational‑retrospective cohort studies concerning prostate cancer surgery under regional anesthesia or general anesthesia. The retrieval time was from the inception of the databases to February 2019. Two researchers screened and collected materials according to the criteria of inclusion. Then, the methodological quality was assessed using the Cochrane risk of bias tool for RCT, and the Newcastle‑Ottawa Scale. Stata 11.0 was used to conduct Meta‑analysis. Results A total of 11 studies (2 RCT studies and 9 observational‑retrospective cohort studies) involving 13 943 prostate cancer patients were included. There were biochemical relapses in 2 RCT studies and 6 observational‑retrospective cohort studies, without statistical difference [RCT: hazard ratio (HR)=1.55, 95%CI (0.86,2.78), P=0.146. Observational studies: HR=0.96, 95%CI (0.79,1.16), P=0.675]. Four observational‑retrospective cohort studies reported no relapse survival. There was no statistical difference in non‑relapse survival time [HR=1.02, 95%CI (0.89,1.16), P=0.829]. Three observational‑retrospective cohort studies reported tumor progression, without statistical difference between the two groups [HR=0.56, 95%CI (0.30,1.04), P=0.065]. Three observational‑retrospective cohort studies calculated the morality of prostate cancer [HR=0.70, 95%CI (0.29,1.68), P=0.418]. Three observational‑retrospective cohort studies reported the all‑cause morality and the results showed that regional anesthesia resulted in a lower all‑cause mortality than general anesthesia [HR=0.77, 95%CI (0.64,0.93), P=0.008]. Conclusions There was no difference between regional anesthesia and general anesthesia in tumor recurrence and metastasis in patients with prostate cancer after surgery between general anesthesia and regional anesthesia. However, regional anesthesia may reduce the overall mortality in prostate cancer patients after surgery.
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