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

doi:10.1016/j.ajur.2022.01.002

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Abstract:

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 strategy.
Methods 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 cancer. Meta-analyses were performed on parameters with available information.
Results A total of 32 RP studies were identified, of which 11 included 26 719 patients with consecutive cohorts and the remaining 21 comprised 24 177 patients with cohorts carrying specific restrictions. Of 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 PSA. Similarly, cases with persistent PSA in different specific patient cohorts with a higher risk of prostate cancer also showed a trend of worse outcomes.
Conclusion We found that the frequency of persistent PSA was about 11.0% in consecutive RP cohorts. Persistent PSA was significantly associated with unfavorable clinicopathological characteristics and worse oncological outcomes. Patients with persistent PSA after RP may benefit from early salvage treatment to delay or prevent biochemical recurrence, improving oncological outcomes for these patients. Further prospective randomized controlled trials are warranted to understand optimal systemic therapy in these patients.

Key words: Prostate cancer Radical prostatectomy Persistent prostate-specific antigen Prognosis Salvage Systematic review Meta-analysis

收稿日期: 2021-08-05 接受日期: 2022-01-25 发布日期: 2023-08-11 整期出版日期: 2023-07-20

引用本文:

. [J]. Asian Journal of Urology, 2023, 10(3): 317-328.
Shulin Wu,Sharron X. Lin,Kristine M. Cornejo,Rory K. Crotty,Michael L. Blute,Douglas M. Dahl,Chin-Lee Wu. Clinicopathological and oncological significance of persistent prostate-specific antigen after radical prostatectomy: A systematic review and meta-analysis. Asian Journal of Urology, 2023, 10(3): 317-328.

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http://www.ajurology.com/CN/10.1016/j.ajur.2022.01.002 或 http://www.ajurology.com/CN/Y2023/V10/I3/317

Reference	Year	Group	Period	Total/persistent (n)	RP cohort	Persist cutoff (ng/mL)	Persistent rate (%)	BCR (ng/mL)	F/U (M)	NOS	Clinical significance of persistent PSA after RP
Micoogullari et al. [8]	2021	Turkey	2009-2017	875/97	Consecutive	≥0.1 at 6-8 weeks	11.1	Two consecutive PSA≥0.2	18-24	9	-0.1-0.2 ng/mL associated with aggressive disease and BCR in UV^a
Milonas et al. [9]	2021	Lithuania	2001-2019	1225/246	Consecutive	≥0.1 at 4-8 weeks	20.1	Two consecutive PSA>0.2	103	7	-Worse outcomes in high risk, worse BCR in intermedium in MV^a
Preisser et al. [10]	2019	Germany	1992-2016	11 604/1025	Consecutive	≥0.1 at 6 weeks	8.8	Two consecutive PSA≥0.2	62	9	-Worse prognosis of Mets, OS, PCSM in MV^a
Spratt et al. [11]	2018	USA	1990-2015	477/150	Consecutive	≥0.1 at 8 weeks	31.4	NA	77	8	-Worse prognosis of Mets in MV^a
García-Barreras et al. [12]	2018	France	2000-2016	2500/229	Consecutive	≥0.1 at 6 weeks	9.2	PSA≥0.2	58	6	-Associated with aggressive disease
Kumar et al. [13]	2017	USA	2008-2013	5300/162	Consecutive	≥0.1 at 6 weeks	3.1	PSA≥0.2	38	7	-Associated with aggressive disease and BCR in UV^a
Audenet et al. [14]	2012	France	1996-2006	240/83	Consecutive	≥0.1 at 6 weeks	34.6	PSA>0.2	44	8	-Worse prognosis of BCR in MV^a
Eisenberg et al. [35]	2010	USA	1996-2006	525/69	Consecutive	>0.05 at 4-12 weeks	13.1	Two consecutive PSA≥0.2	56	8	-Worse 5-year BCR prognosis in MV^a
Moreira et al. [36]	2010	USA	2001-2008	901/230	Consecutive	≥0.03 at 4-24 weeks	25.5	PSA>0.2	≥6	8	-≥0.03 ng/mL showed aggressive features and BCR outcome in MV^a
Naselli et al. [15]	2009	Italy	2002-2007	318/33	Consecutive	≥0.1 at 6 weeks	10.3	PSA>0.4	5	8	-Associated with aggressive disease, worse BCR outcome in MV^a
Sengupta et al. [16]	2006	USA	1990-1999	2754/303	Consecutive	>0.1/0.15 at 8-16 weeks	11.0	NA	102	7	-Worse prognosis of Mets and PCSM in MV^a
Sood et al. [37]	2020	USA	NA	NA/760	RTOG9601	>0.4	NA	PSA 0.2-4.0	144	6	-Worse local recurrence, Mets, and OS than BCR patients in UV^a
Venclovas et al. [17]	2019	Lithuania	2001-2017	433/130	High-risk PCa	≥0.1 at 6-8 weeks	30.0	Two consecutive PSA≥0.2	64	8	-Predict Mets and PCSM in UV^a but not in MV; early BCR
Roy et al. [38]	2019	Canada	2005-2014	167/52	pN1	≥0.2 at 4-8 weeks	31.1	>0.2	48	6	-Worse prognosis of Mets in MV^a, not in OS
Kim et al. [18]	2019	Korea	2002-2014	96/52	pN1	≥0.1 at 6 weeks	54.2	Two consecutive PSA>0.2	45	7	-Worse prognosis of Mets in MV^a
Bartkowiak et al. [19]	2019	Germany	1997-2002	555/133	pN0, SRT	≥0.1	24.0	Two consecutive PSA≥0.2	73	7	-Worse PFS prognosis in UV^a but not in MV by pre-SRT PSA
Xiang et al. [20]	2018	China	2009-2014	198/104	Persistent	≥0.1 and < 0.2 at 6-8 weeks	NA	Two consecutive PSA≥0.2	53	6	-RT and ADT control BCR progress well in MV^a
Schmidt-Hegemann et al. [39]	2018	Germany	2014-2017	129/67	PSMA PET/CT RT	Undefined	52.0	PSA>0.2	20	6	-With high-risk PCa and shorter time interval to BCR before Tx
McDonald et al. [40]	2018	USA	1982-2015	124/44	pN1	≥0.2	35.5	PSA≥0.2	98	7	-Associated with Mets in MV^a
Fossati et al. [21]	2018	Italy	1996-2009	925/324	SRT	≥0.1 at 4 weeks	35.0	PSA≥0.1	96	7	-Worse Mets prognosis treated with SRT in MV^a
Gandaglia et al. [22]	2017	Italy	1994-2014	982/496	Persistent	≥0.1 at 6-8 weeks	NA	NA	110	6	-Worse PCSM prognosis in UV^a, RT benefit
Bianchi et al. [23]	2016	Italy	1998-2013	391/83	pN1	≥0.1 at 6 weeks	26.0	PSA≥0.2	53	7	-Worse Mets and PCSM prognosis in MV^a
Ploussard et al. [24]	2013	France	1998-2011	9735/496	Persistent	≥0.1 at 6 weeks	NA	NA	27	6	-Worse BCR prognosis and worse salvage Tx outcome in MV^a
Lohm et al. [25]	2013	Germany	1997-2004	159/72	BCR, SRT	≥0.1	45.3	PSA≥0.1	42	7	-Similar BCR prognosis as undetectable, SRT benefit
Rogers et al. [26]	2004	USA	1989-2002	2680/160	Persistent	≥0.1 at 12 weeks	NA	NA	≥12	6	-PSA change ≥0.05 ng/mL showed worse Mets prognosis in UV^a
Song et al. [27]	2002	USA	1989-1999	NA/73	SRT	≥0.1	NA	NA	36	6	-Worse disease PFS after RT in UV^a
Catton et al. [41]	2001	Canada	1987-1994	113/21	ART, SRT	≥0.2	18.6	NA	44	6	-Worse BCR prognosis than undetectable in UV^a
Garg et al. [42]	1998	USA	1991-1997	78/37	SRT	≥0.05	47.4	NA	27	7	-Similar 3 years disease-free survival as undetectable
Coetzee et al. [43]	1996	USA	NA	45/15	PSM, ART	≥0.5	33.3	NA	33	6	-80% disease progress, may with micro Mets or local disease
Wu et al. [28]	1995	USA	1987-1993	53/38	RT	Decreased from 0.3 to 0.1	82.6	NA	15	7	-Predict less undetectable PSA after RT in UV^a but not in MV
Link et al. [44]	1991	USA	1984-1988	25/12	ART	Undefined	48.0	NA	33	6	-Less durable response after RT
Hudson and Catalona [30]	1990	USA	1983-1988	80/21	RT	>0.6	26.3	NA	13	6	-At risk of further progression

[1]	Cooperberg MR, Carroll PR.Trends in management for patients with localized prostate cancer, 1990e 2013. JAMA 2015; 314:80-2. doi: 10.1001/jama.2015.6036
[2]	Oesterling JE, Chan DW, Epstein JI, Kimball Jr AW, Bruzek DJ, Rock RC, et al. Prostate specific antigen in the preoperative and postoperative evaluation of localized prostatic cancer treated with radical prostatectomy. J Urol 1988; 139:766-72. doi: 10.1016/s0022-5347(17)42630-9 pmid: 2451037
[3]	Sanda MG, Cadeddu JA, Kirkby E, Chen RC, Crispino T, Fontanarosa J, et al. Clinically localized prostate cancer: AUA/ASTRO/SUO guideline. Part II: recommended approaches and details of specific care options. J Urol 2018; 199:990-7. doi: S0022-5347(18)30014-4 pmid: 29331546
[4]	Mottet N, Bellmunt J, Bolla M, Briers E, Cumberbatch MG, De Santis M, et al. EAU-ESTRO-SIOG guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol 2017; 71:618-29. doi: S0302-2838(16)30470-5 pmid: 27568654
[5]	Pound CR, Partin AW, Eisenberger MA, Chan DW, Pearson JD, Walsh PC. Natural history of progression after PSA elevation following radical prostatectomy. JAMA 1999; 281:1591-7. doi: 10.1001/jama.281.17.1591
[6]	Antonarakis ES, Feng Z, Trock BJ, Humphreys EB, Carducci MA, Partin AW, et al. The natural history of metastatic progression in men with prostate-specific antigen recurrence after radical prostatectomy: long-term follow-up. BJU Int 2012; 109:32-9.
[7]	Kim DK, Koo KC, Lee KS, Hah YS, Rha KH, Hong SJ, et al. Time to disease recurrence is a predictor of metastasis and mortality in patients with high-risk prostate cancer who achieved undetectable prostate-specific antigen following robotassisted radical prostatectomy. J Kor Med Sci 2018; 33:e285. https://doi.org/10.3346/jkms.2018.33.e285. doi: 10.3346/jkms.2018.33.e285
[8]	Micoogullari U, Cakici MC, Kisa E, Canda AE, Kilic FU, Ardicoglu A, et al. A risk grouping algorithm for predicting factors of persistently elevated prostate-specific antigen in patients following robot-assisted radical prostatectomy. Int J Clin Pract 2021:e14495. https://doi.org/10.1111/ijcp.14495.
[9]	Milonas D, Venclovas Z, Sasnauskas G, Ruzgas T. The significance of prostate specific antigen persistence in prostate cancer risk groups on long-term oncological outcomes. Cancers 2021; 13:2453. https://doi.org/10.3390/cancers13102453. doi: 10.3390/cancers13102453
[10]	Preisser F, Chun FKH, Pompe RS, Heinze A, Salomon G, Graefen M, et al. Persistent prostate-specific antigen after radical prostatectomy and its impact on oncologic outcomes. Eur Urol 2019; 76:106-14. doi: S0302-2838(19)30094-6 pmid: 30772034
[11]	Spratt DE, Dai DLY, Den RB, Troncoso P, Yousefi K, Ross AE, et al. Performance of a prostate cancer genomic classifier in predicting metastasis in men with prostate-specific antigen persistence postprostatectomy. Eur Urol 2018; 74:107-14. doi: S0302-2838(17)31016-3 pmid: 29233664
[12]	García-Barreras S, Rozet F, Nunes-Silva I, Srougi V, Sanchez-Salas R, Barret E, et al. Predictive factors and the important role of detectable prostate-specific antigen for detection of clinical recurrence and cancer-specific mortality following robot-assisted radical prostatectomy. Clin Transl Oncol 2018; 20:1004-10. doi: 10.1007/s12094-017-1812-1 pmid: 29243074
[13]	Kumar A, Samavedi S, Mouraviev V, Bates AS, Coelho RF, Rocco B, et al. Predictive factors and oncological outcomes of persistently elevated prostate-specific antigen in patients following robot-assisted radical prostatectomy. J Robot Surg 2017; 11:37-45. doi: 10.1007/s11701-016-0606-8 pmid: 27245233
[14]	Audenet F, Seringe E, Drouin SJ, Comperat E, Cussenot O, Bitker MO, et al. Persistently elevated prostate-specific antigen at six weeks after radical prostatectomy helps in early identification of patients who are likely to recur. World J Urol 2012; 30:239-44. doi: 10.1007/s00345-011-0707-y pmid: 21638225
[15]	Naselli A, Introini C, Andreatta R, Spina B, Truini M, Puppo P. Prognostic factors of persistently detectable PSA after radical prostatectomy. Int J Urol 2009; 16:82-6. doi: 10.1111/j.1442-2042.2008.02198.x pmid: 19054168
[16]	Sengupta S, Christensen CM, Zincke H, Slezak JM, Leibovich BC, Bergstralh EJ, et al. Detectable prostate specific antigen between 60 and 120 days following radical prostatectomy for prostate cancer: natural history and prognostic significance. J Urol 2006;176:559-63.
[17]	Venclovas Z, Jievaltas M, Milonas D. Significance of time until psa recurrence after radical prostatectomy without neo- or adjuvant treatment to clinical progression and cancer-related death in high-risk prostate cancer patients. Front Oncol 2019; 9:1286. https://doi.org/10.3389/fonc.2019.01286. doi: 10.3389/fonc.2019.01286 pmid: 31824859
[18]	Kim JK, Jeong CW, Ku JH, Kim HH, Kwak C. Prostate specific antigen (PSA) persistence 6 weeks after radical prostatectomy and pelvic lymph node dissection as predictive factor of radiographic progression in node-positive prostate cancer patients. J Cancer 2019; 10:2237-42. doi: 10.7150/jca.29714 pmid: 31258727
[19]	Bartkowiak D, Siegmann A, Bohmer D, Budach V, Wiegel T, et al. The impact of prostate-specific antigen persistence after radical prostatectomy on the efficacy of salvage radiotherapy in patients with primary N0 prostate cancer. BJU Int 2019; 124:785-91. doi: 10.1111/bju.14851 pmid: 31220400
[20]	Xiang C, Liu X, Chen S, Wang P. Prediction of biochemical recurrence following radiotherapy among patients with persistent psa after radical prostatectomy: a single-center experience. Urol Int 2018; 101:47-55. doi: 10.1159/000488536 pmid: 29627830
[21]	Fossati N, Karnes RJ, Colicchia M, Boorjian SA, Bossi A, Seisen T, et al. Impact of early salvage radiation therapy in patients with persistently elevated or rising prostate-specific antigen after radical prostatectomy. Eur Urol 2018; 73:436-44. doi: S0302-2838(17)30655-3 pmid: 28779974
[22]	Gandaglia G, Boorjian SA, Parker WP, Zaffuto E, Fossati N, Bandini M, et al. Impact of postoperative radiotherapy in men with persistently elevated prostate-specific antigen after radical prostatectomy for prostate cancer: a long-term survival analysis. Eur Urol 2017; 72:910-7. doi: S0302-2838(17)30496-7 pmid: 28622831
[23]	Bianchi L, Nini A, Bianchi M, Gandaglia G, Fossati N, Suardi N, et al. The role of prostate-specific antigen persistence after radical prostatectomy for the prediction of clinical progression and cancer-specific mortality in node-positive prostate cancer patients. Eur Urol 2016; 69:1142-8. doi: 10.1016/j.eururo.2015.12.010 pmid: 26749093
[24]	Ploussard G, Staerman F, Pierrevelcin J, Saad R, Beauval JB, Roupret M, et al. Predictive factors of oncologic outcomes in patients who do not achieve undetectable prostate specific antigen after radical prostatectomy. J Urol 2013; 190:1750-6. doi: 10.1016/j.juro.2013.04.073 pmid: 23643600
[25]	Lohm G, Bottke D, Jamil B, Miller K, Neumann K, Bartkowiak D, et al. Salvage radiotherapy in patients with persistently detectable PSA or PSA rising from an undetectable range after radical prostatectomy gives comparable results. World J Urol 2013; 31:423-8. doi: 10.1007/s00345-012-0860-y pmid: 22460203
[26]	Rogers CG, Khan MA, Craig Miller M, Veltri RW, Partin AW. Natural history of disease progression in patients who fail to achieve an undetectable prostate-specific antigen level after undergoing radical prostatectomy. Cancer 2004; 101:2549-56. pmid: 15470681
[27]	Song DY, Thompson TL, Ramakrishnan V, Harrison R, Bhavsar N, Onaodowan O, et al. Salvage radiotherapy for rising or persistent PSA after radical prostatectomy. Urology 2002; 60:281-7. pmid: 12137827
[28]	Wu JJ, King SC, Montana GS, McKinstry CA, Anscher MS. The efficacy of postprostatectomy radiotherapy in patients with an isolated elevation of serum prostate-specific antigen. Int J Radiat Oncol Biol Phys 1995; 32:317-23. doi: 10.1016/0360-3016(95)00083-B
[29]	Ravery V. The significance of recurrent PSA after radical prostatectomy: benign versus malignant sources. Semin Urol Oncol 1999; 17:127-9. pmid: 10462314
[30]	Hudson MA, Catalona WJ. Effect of adjuvant radiation therapy on prostate specific antigen following radical prostatectomy. J Urol 1990; 143:1174-7. doi: 10.1016/s0022-5347(17)40218-7 pmid: 1692887
[31]	Kimura S, Urabe F, Sasaki H, Kimura T, Miki K, Egawa S. Prognostic significance of prostate-specific antigen persistence after radical prostatectomy: a systematic review and meta-analysis. Cancers 2021; 13:948. https://doi.org/10.3390/cancers13050948. doi: 10.3390/cancers13050948
[32]	Ploussard G, Fossati N, Wiegel T, D’Amico A, Hofman MS, Gillessen S, et al. Management of persistently elevated prostate-specific antigen after radical prostatectomy: a systematic review of the literature. Eur Urol Oncol 2021; 4: 150-69. doi: 10.1016/j.euo.2021.01.001 pmid: 33574012
[33]	Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 2009; 62:e1-34. https://doi.org/10.1016/j.jclinepi.2009.06.006. doi: 10.1016/j.jclinepi.2009.06.006
[34]	Sterne JA, Hernan MA, Reeves BC, Savovic J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 2016; 355: i4919. https://doi.org/10.1136/bmj.i4919.
[35]	Eisenberg ML, Davies BJ, Cooperberg MR, Cowan JE, Carroll PR. Prognostic implications of an undetectable ultrasensitive prostate-specific antigen level after radical prostatectomy. Eur Urol 2010; 57:622-9. doi: 10.1016/j.eururo.2009.03.077 pmid: 19375843
[36]	Moreira DM, Presti Jr JC, Aronson WJ, Terris MK, Kane CJ, Amling CL, et al. Definition and preoperative predictors of persistently elevated prostate-specific antigen after radical prostatectomy: results from the Shared Equal Access Regional Cancer Hospital (SEARCH) database. BJU Int 2010; 105:1541-7.
[37]	Sood A, Keeley J, Palma-Zamora I, Arora S, Dalela D, Olson P, et al. Ten-year disease progression and mortality rates in men who experience biochemical recurrence versus persistence after radical prostatectomy and undergo salvage radiation therapy: a post-hoc analysis of RTOG 9601 trial data. Urol Oncol 2020; 38:599. e1-8. https://doi.org/10.1016/j.urolonc.2020.02.024.
[38]	Roy S, Sia M, Tyldesley S, Bahl G. Pathologically node-positive prostate carcinomadprevalence, pattern of care and outcome from a population-based study. Clin Oncol 2019; 31:91-8. doi: 10.1016/j.clon.2018.10.005
[39]	Schmidt-Hegemann NS, Fendler WP, Ilhan H, Herlemann A, Buchner A, Stief C, et al. Outcome after PSMA PET/CT based radiotherapy in patients with biochemical persistence or recurrence after radical prostatectomy. Radiat Oncol 2018; 13: 37. https://doi.org/10.1186/s13014-018-0983-4. doi: 10.1186/s13014-018-0983-4 pmid: 29499730
[40]	McDonald ML, Howard LE, Aronson WJ, Terris MK, Cooperberg MR, Amling CL, et al. First postoperative PSA is associated with outcomes in patients with node positive prostate cancer: results from the SEARCH database. Urol Onc ol 2018; 36:239. e17-25. https://doi.org/10.1016/j.urolonc.2018.01.005.
[41]	Catton C, Gospodarowicz M, Warde P, Panzarella T, Catton P, McLean M, et al. Adjuvant and salvage radiation therapy after radical prostatectomy for adenocarcinoma of the prostate. Radiother Oncol 2001; 59:51-60. pmid: 11295206
[42]	Garg MK, Tekyi-Mensah S, Bolton S, Velasco J, Pontes E, Wood Jr DP, et al. Impact of postprostatectomy prostatespecific antigen nadir on outcomes following salvage radiotherapy. Urology 1998; 51:998-1002. pmid: 9609639
[43]	Coetzee LJ, Hars V, Paulson DF. Postoperative prostatespecific antigen as a prognostic indicator in patients with margin-positive prostate cancer, undergoing adjuvant radiotherapy after radical prostatectomy. Urology 1996; 47:232-5. pmid: 8607240
[44]	Link P, Freiha FS, Stamey TA. Adjuvant radiation therapy in patients with detectable prostate specific antigen following radical prostatectomy. J Urol 1991; 145:532-4. doi: 10.1016/s0022-5347(17)38388-x pmid: 1705294
[45]	Tilki D, Kim SI, Hu B, Dall'Era MA, Evans CP. Ultrasensitive prostate specific antigen and its role after radical prostatectomy: a systematic review. J Urol 2015; 193:1525-31. doi: 10.1016/j.juro.2014.10.087 pmid: 25444980
[46]	Hu JC, Gandaglia G, Karakiewicz PI, Nguyen PL, Trinh QD, Shih YC, et al. Comparative effectiveness of robot-assisted versus open radical prostatectomy cancer control. Eur Urol 2014; 66:666-72. doi: 10.1016/j.eururo.2014.02.015 pmid: 24602934
[47]	Han M, Partin AW, Piantadosi S, Epstein JI, Walsh PC. Era specific biochemical recurrence-free survival following radical prostatectomy for clinically localized prostate cancer. J Urol 2001; 166:416-9. pmid: 11458039
[48]	D'Amico AV, Whittington R, Malkowicz SB, Schultz D, Blank K, Broderick GA, et al. Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 1998; 280:969-74. doi: 10.1001/jama.280.11.969
[49]	Godoy G, Tareen BU, Lepor H. Does benign prostatic tissue contribute to measurable PSA levels after radical prostatectomy? Urology 2009; 74:167-70.
[50]	Zietman AL, Edelstein RA, Coen JJ, Babayan RK, Krane RJ. Radical prostatectomy for adenocarcinoma of the prostate: the influence of preoperative and pathologic findings on biochemical disease-free outcome. Urology 1994; 43:828-33. pmid: 7515206
[51]	Vesely S, Jarolim L, Duskova K, Schmidt M, Dusek P, Babjuk M. The use of early postoperative prostate-specific antigen to stratify risk in patients with positive surgical margins after radical prostatectomy. BMC Urol 2014; 14:79. https://doi.org/10.1186/1471-2490-14-79. doi: 10.1186/1471-2490-14-79 pmid: 25277310
[52]	Fowler JE Jr, Brooks J, Pandey P, Seaver LE. Variable histology of anastomotic biopsies with detectable prostate specific antigen after radical prostatectomy. J Urol 1995; 153:1011-4. pmid: 7531783
[53]	Stephenson AJ, Scardino PT, Kattan MW, Pisansky TM, Slawin KM, Klein EA, et al. Predicting the outcome of salvage radiation therapy for recurrent prostate cancer after radical prostatectomy. J Clin Oncol 2007; 25:2035-41. doi: 10.1200/JCO.2006.08.9607 pmid: 17513807
[54]	Skove SL, Howard LE, Aronson WJ, Terris MK, Kane CJ, Amling CL, et al. Timing of prostate-specific antigen nadir after radical prostatectomy and risk of biochemical recurrence. Urology 2017; 108:129-34. doi: S0090-4295(17)30742-2 pmid: 28735016
[55]	Vesely S, Jarolim L, Schmidt M, Minarik I, Dusek P, Babjuk M. Parameters derived from the postoperative decline in ultrasensitive PSA improve the prediction of radical prostatectomy outcome. World J Urol 2013; 31:299-304. doi: 10.1007/s00345-012-0892-3 pmid: 22684375
[56]	Murgic J, Jaksic B, Prpic M, Kust D, Bahl A, Budanec M, et al. Comparison of hypofractionation and standard fractionation for post-prostatectomy salvage radiotherapy in patients with persistent PSA: single institution experience. Radiat Oncol 2021; 16:88. https://doi.org/10.1186/s13014-021-01808-3. doi: 10.1186/s13014-021-01808-3 pmid: 33980277
[57]	Stish BJ, Pisansky TM, Harmsen WS, Davis BJ, Tzou KS, Choo R, et al. Improved metastasis-free and survival outcomes with early salvage radiotherapy in men with detectable prostatespecific antigen after prostatectomy for prostate cancer. J Clin Oncol 2016; 34:3864-71. doi: 10.1200/JCO.2016.68.3425
[58]	Gandaglia G, Briganti A, Clarke N, Karnes RJ, Graefen M, Ost P, et al. Adjuvant and salvage radiotherapy after radical prostatectomy in prostate cancer patients. Eur Urol 2017; 72: 689-709. doi: S0302-2838(17)30064-7 pmid: 28189428

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[5]	Ponco Birowo,Nur Rasyid,Chaidir A. Mochtar,Bambang S. Noegroho,H.R. Danarto,Besut Daryanto,Lukman Hakim,Dyandra Parikesit,Fakhri Rahman,S. Cahyo Ariwicaksono. Daily activities and training experiences of urology residents during the coronavirus disease 2019 pandemic in Indonesia: A nationwide survey[J]. Asian Journal of Urology, 2023, 10(2): 119 -127 .
[6]	Tarun Jindal, Pravin Pawar, Neeraj Subedi. Concurrent laparoscopic management of giant adrenal myelolipoma and contralateral renal cell carcinoma[J]. Asian Journal of Urology, 2022, 9(1): 97 -98 .
[7]	Melanie R. Müller,Margaretha A.Skowron,Peter Albers,Daniel Nettersheim. Molecular and epigenetic pathogenesis of germ cell tumors[J]. Asian Journal of Urology, 2021, 8(2): 144 -154 .
[8]	Bendu K. Konneh, John T. Lafin, Aditya Bagrodia. Referring to the article published on pp. 400-406 of this issue: Progress and challenges in testicular cancer microRNAs[J]. Asian Journal of Urology, 2021, 8(4): 341 -342 .
[9]	Edward K. Chang,Adam J. Gadzinski,Yaw A. Nyame. Blood and urine biomarkers in prostate cancer: Are we ready for reflex testing in men with an elevated prostate-specific antigen?[J]. Asian Journal of Urology, 2021, 8(4): 343 -353 .
[10]	Luke P. O’Connor,Shayann Ramedani,Michael Daneshvar,Arvin K. George,Andre Luis Abreu,Giovanni E. Cacciamani,Amir H. Lebastchi. Future perspective of focal therapy for localized prostate cancer[J]. Asian Journal of Urology, 2021, 8(4): 354 -361 .

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