Eleven comparative studies (n=1,443: 486 patients had undergone APER and 957 had undergone AR) were included. Three studies were prospective and eight were retrospective.
In 3 studies the groups were matched on at least one variable; the other studies reported no matching. Four studies were classified as high quality. There were no significant differences between treatment groups in the mean age of the patients.
There was no significant difference in general health score between APER and AR.
Vitality (WMD -9.82, 95% CI: -27.01, -2.04, p=0.01; 3 high-quality studies using the SF-36) and sexual function (WMD -2.73, 95% CI: -4.93, -0.64, p=0.01; 5 studies using the QLQ CR38) were greater for AR patients than for APER patients.
Physical function was greater for patients with low AR than for APER patients (WMD -4.67, 95% CI: -9.10, -0.23, p=0.004; 5 studies using the QLQ C30).
Cognitive function scores (WMD 3.57, 95% CI: 1.41, 5.73, p<0.001; 5 studies using the QLQ C30) and emotional function scores (WMD 3.51, 95% CI: 1.40, 5.62, p<0.001; 5 studies using the QLQ C30) were greater for APER patients than for AR patients.
The results of other individual domains were reported.