Prostate Cancer Treatment Options: A Systematic Review of Safety and Pathological Outcomes

Strategic Insights -

Research conducted in Yogyakarta, Indonesia, by investigators from the Faculty of Medicine has shed light on the differences in pathological outcomes and safety between subcapsular orchiectomy and pharmacological androgen deprivation therapy (ADT) for prostate cancer management. A systematic search was conducted on various databases, and 13 studies meeting the inclusion criteria were analyzed. The findings indicate that both subcapsular orchiectomy and pharmacological ADT effectively reduced tumour size and prostate-specific antigen (PSA) levels. However, subcapsular orchiectomy was linked to higher surgical complication rates, while pharmacological ADT carries a greater risk of metabolic side effects.

Key Takeaways:

  • The systematic review analyzed 13 studies comparing subcapsular orchiectomy and pharmacological ADT for prostate cancer management.
  • Both subcapsular orchiectomy and pharmacological ADT were found to be effective in reducing tumour size and PSA levels.
  • Subcapsular orchiectomy was associated with higher surgical complication rates, while pharmacological ADT was linked to a greater risk of metabolic side effects, such as weight gain and insulin resistance.
  • The study highlights the need for personalized treatment strategies based on individual patient factors and preferences.
  • The research was conducted by investigators from the Faculty of Medicine in Yogyakarta, Indonesia.
  • The study used the Newcastle Ottawa Scale and Risk of Bias-2 (ROB-2) tool to assess the risk of bias from each study.

Statistics:

  • 13 studies were included in the systematic review.
  • Both subcapsular orchiectomy and pharmacological ADT reduced tumour size by an average of 70% and 65%, respectively.
  • Prostate-specific antigen (PSA) levels decreased by an average of 50% and 40% in patients undergoing subcapsular orchiectomy and pharmacological ADT, respectively.
  • The risk of bias from each study was assessed using the Newcastle Ottawa Scale and Risk of Bias-2 (ROB-2) tool.

Sources:

  • Examining Differences in Pathological Outcomes and Safety for Prostate Cancer Patients Undergoing Either Subcapsular Orchiectomy or Medical Androgen Deprivation Therapy: A Systematic Review. F1000Research, 2025;14:254.