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The impact of PTEN deletion and ERG rearrangement on recurrence after treatment for prostate cancer: a systematic review and meta-analysis

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Abstract

Background

The specific association between PTEN deletion or ERG rearrangement and the recurrence of prostate cancer (PC) treated with radical prostatectomy (RP) or brachytherapy is still unelaborated. Therefore, we performed a comprehensive meta‑analysis to understand the impact of these factors on cancer recurrence.

Methods

A comprehensive literature search was performed in November 2018 based on PUBMED, EMBASE and Web of science database. Hazard ratio (HR) for biochemical recurrence free (BRF) which was defined as a PSA greater than or equal to 0.4 ng/mL after RP or another therapy for any detectable PSA and recurrence-free survival (RFS) which defined the time from the beginning of treatment to the earliest occurrence of local recurrence, distant metastasis or death. Which were extracted from eligible studies. I2 value was used to assess the pooled heterogeneity.

Result

A total of 6744 patients from 17 studies were included in this analysis Overall, The pooled results showed that PTEN loss predict pooled BRF (HR 1.79, 95% CI 1.49–2.16, P < 0.001) and RFS (HR 1.71, 95% CI 1.50–1.95, P < 0.001) in patients after radical prostatectomy or brachytherapy for prostate cancer. Subgroup analysis revealed that PTEN deletion significantly predicted poor BRF or RFS in heterozygous studies group (HR 1.70, 95% CI 1.31–2.21, P < 0.001). The PTEN deletion also significantly predicted poor BRF or PFS in homozygous studies (HR 2.54, 95% CI 1.89–3.17, P < 0.001). And we had found that there was no significant association between ERG rearrangement and cancer recurrence regardless of PTEN loss or not. In addition, we concluded that Gleason score > 6 significantly predicted the poor BRF or RFS in studies, especially in Gleason score = 4 + 3 (HR 3.16, 95% CI 2.08–4.80, P < 0.01).

Conclusion

This study presented that PTEN deletion significantly reduce time of BRF or RFS, especially based on homozygous deletion. And we also found ERG rearrangement in tumor cell could not significantly predict BRF or RFS.

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Abbreviations

BRF:

Biochemical recurrence free

RFS:

Recurrence-free survival

RP:

Radical prostatectomy

CIs:

Confidence intervals

HRs:

Hazard ratios

NOS:

Newcastle–Ottawa Scale

PC:

Prostate cancer

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Acknowledgements

We owe our thanks to Shuai Xia and Tao Li for their work on revising and data extracting in this manuscript.

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Authors and Affiliations

  1. Department of Urology, The Second Hospital of Tianjin Medical University, No. 23, Pingjiang Road, Hexi District, Tianjin, 300211, China

    R. Liu, J. Zhou, S. Xia & T. Li

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  1. R. Liu
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  2. J. Zhou
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  3. S. Xia
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  4. T. Li
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Contributions

Conception and Design: JZ and DF; Extraction of Data: TL; Quality assessment: JZ and SX; Drafting the Article: JZ and DF; Revising It for Intellectual Content: RL; Final Approval of the Completed Article: JZ, RL. All authors read and approved the final manuscript.

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Correspondence to R. Liu.

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Liu, R., Zhou, J., Xia, S. et al. The impact of PTEN deletion and ERG rearrangement on recurrence after treatment for prostate cancer: a systematic review and meta-analysis. Clin Transl Oncol 22, 694–702 (2020). https://doi.org/10.1007/s12094-019-02170-3

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  • DOI: https://doi.org/10.1007/s12094-019-02170-3

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