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Clinicopathological and oncological significance of persistent prostate-specific antigen after radical prostatectomy:A systematic review and meta-analysis

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Asian Journal of Urology 2023年第3期10卷 317-328页

作者： Shulin Wu Sharron X.Lin Kristine M.Cornejo Rory K.Crotty Michael L.Blute Douglas M.Dahl Chin-Lee Wu Department of Urology Massachusetts General HospitalHarvard Medical SchoolBostonMAUSA Department of Pathology Massachusetts General HospitalHarvard Medical SchoolBostonMAUSA

Objective:To investigate the association of persistently elevated prostate-specific antigen(PSA)after radical prostatectomy(RP)with clinicopathological features and long-term oncological prognosis for the development of a potential management ***:A systematic literature search was performed using PubMed and Web of Science up to June 2021 to identify the eligible studies focusing on understanding the impact of persistent PSA in patients who underwent RP for localized prostate ***-analyses were performed on parameters with available ***:A total of 32 RP studies were identified,of which 11 included 26719 patients with consecutive cohorts and the remaining 21 comprised 24177 patients with cohorts carrying specific *** the 11 studies with consecutive cohorts,the incidence of persistent PSA varied between 3.1%and 34.6%with a median of 11.0%.Meta-analyses revealed patients with persistent PSA consistently showed unfavorable clinicopathological features and a more than 3.5-fold risk of poorer biochemical recurrence,metastasis,and prostate cancer-specific mortality prognosis independently,when compared to patients with undetectable ***,cases with persistent PSA in different specific patient cohorts with a higher risk of prostate cancer also showed a trend of worse ***:We found that the frequency of persistent PSA was about 11.0%in consecutive RP *** PSA was significantly associated with unfavorable clinicopathological characteristics and worse oncological *** with persistent PSA after RP may benefit from early salvage treatment to delay or prevent biochemical recurrence,improving oncological outcomes for these *** prospective randomized controlled trials are warranted to understand optimal systemic therapy in these patients.

关键词： Prostate cancer Radical prostatectomy persistent prostatespecific antigen Prognosis Salvage Systematic review Meta-analysis

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