MEDLINE (1980 through February 2002), CANCERLIT (1980 through October 2001) and the Cochrane Library databases (2001, Issue 4) were systematically searched. For the most recent searches (1998 through February 2002 in MEDLINE and 1988 through October 2001 in CANCERLIT), "prostatic neoplasms" (Medical subject heading [MeSH]) was combined with "gonadorelin" (MeSH), "androgen antagonists" (MeSH), "diethylstilbestrol" (MeSH), "castration" (MeSH), and each of the following words or phrases used as text words: "leuprolide", "lupron", "goserelin", "zoladex", "buserelin", "suprefact", "flutamide", "eulexin", "nilutamide", "anandron", "nilandron", "bicalutamide", "casodex", "cyproterone acetate", "androcur", "diethylstilbestrol", "DES", "castration", "orchidectomy", "orchiectomy", "prostatic cancer", "prostate cancer". These terms were then combined with the search terms for the following study designs: practice guidelines, systematic reviews or meta-analyses, reviews, randomized controlled trials, and controlled clinical trials. In addition, the Physician Data Query (PDQ) clinical trials database on the Internet (http://www.cancer.gov/search/clinical_trials/) was searched for reports of new or on-going trials. Relevant articles were selected and reviewed by two reviewers, and the reference lists from these sources were searched for additional trials, as were the reference lists from relevant review articles. Genitourinary Disease Site Group (GU DSG) members contributed papers from their personal reprint files. The Canadian Medical Association Infobase (http://mdm.ca/cpgsnew/cpgs/index.asp) and the National Guideline Clearinghouse (http://www.guideline.gov/) were searched for existing evidence-based practice guidelines.
Inclusion Criteria
Articles were selected for inclusion in this systematic review of the evidence if they met the following criteria:
- Published reports of randomized controlled trials (RCTs) or meta-analyses comparing MAB (orchiectomy or luteinizing hormone-releasing hormone [LHRH] agonist plus administration of an antiandrogen) with castration alone (orchiectomy or administration of a luteinizing hormone-releasing hormone agonist) in previously untreated men with metastatic prostate cancer.
- Published reports providing data on overall survival and/or disease progression-related outcomes.
Exclusion criteria
- Phase I and phase II trials were excluded from this report due to the availability of randomized controlled trials and meta-analyses.
- Papers published in a language other than English, letters, and editorials were also excluded.