前列腺癌的前列腺外扩展 (EPE) 通常被报告为局灶性 (F-EPE) 或已确立的 (E-EPE)，但有关该细分结果的影响的数据是相互矛盾的，并且不存在评估这一点的系统评价 (SR)。本 SR 旨在弥补文献中的这一空白，重点关注 F-EPE 和 E-EPE 对根治性前列腺切除术 (RP) 患者预后的影响。对 Embase、Medline(R) 和 Pubmed 数据库进行了检索。如果研究调查了 RP 患者的 EPE 程度并将其与确定的结果（生化复发 [BCR]、死亡、转移）相关联，则纳入研究。使用纽卡斯尔-渥太华量表评估质量。随机效应模型用于报告风险比（EPE 范围和生化复发）的研究。纳入 24 项研究，其中包括 49,187 名男性。六项研究质量很高。 20 项研究报告了他们如何测量 EPE。 13 项研究报告称，EPE 的程度与 BCR 显着相关。荟萃分析显示，与器官局限性疾病相比，BCR 与 F-EPE 和 E-EPE 之间存在显着相关性； F-EPE 和 E-EPE 之间没有发现显着差异。这是唯一调查 EPE 对 RP 后结果影响程度的 SR。 EPE 单独预测结果，但无法证明按范围细分的价值。由于 EPE 评估和文献中报告结果的方法存在差异，比较受到限制。在更大的队列中进一步标准化 EPE 报告方法可能有助于解决剩余问题。© 2024 作者。组织病理学由约翰·威利出版

Extraprostatic extension (EPE) of prostate cancer is usually reported as either focal (F-EPE) or established (E-EPE), but data on the implication for outcomes of this subdivision are conflicting and no systematic review (SR) evaluating this exists. This SR aims to address this gap in the literature, focusing on the impact of F-EPE and E-EPE on outcome in radical prostatectomy (RP) patients. Searches on Embase, Medline(R), and Pubmed databases were conducted. Studies were included if they investigated the extent of EPE in RP patients and correlated this with defined outcomes (biochemical recurrence [BCR], death, metastasis). Quality was assessed using the Newcastle-Ottawa Scale. A random effects model was used for studies reporting hazard ratios (EPE extent and biochemical recurrence). 24 studies, including 49,187 men, were included. Six studies were of high quality. 20 studies reported how they measured EPE. 13 studies reported that the extent of EPE was associated significantly with BCR. Meta-analysis showed there was a significant correlation between BCR and both F-EPE and E-EPE when compared to organ-confined disease; no significant difference was found between F-EPE and E-EPE. This is the only SR to investigate the extent of EPE on outcomes after RP. EPE alone predicts outcome, but the value of subdivision by extent could not be demonstrated. Comparisons are limited due to variability in EPE assessment and in the methods used to report outcomes in the literature. Further work to standardize EPE reporting methods, in larger cohorts, may be helpful to resolve remaining questions.© 2024 The Author(s). Histopathology published by John Wiley & Sons Ltd.