Causes of Prostate Cancer Recurrence After Radical Prostatectomy
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Prostate cancer recurrence following radical prostatectomy (RP) poses significant challenges for patient management and long-term outcomes. The objective of this study was to summarize the main factors associated with prostate cancer recurrence after radical prostatectomy. A scoping review was conducted using the PubMed database with keywords including ‘prostate cancer recurrence after radical prostatectomy,’ ‘biochemical recurrence,’ and ‘surgical margins.’ The search was limited to English-language studies published between 2020–2025. Inclusion criteria focused on clinical and case report studies involving recurrence post-RP with a minimum of 12-month follow-up. A total of 4,736 articles were identified, with 23 studies meeting all eligibility criteria. Recurrence was primarily associated with positive surgical margins, Gleason score, PSA kinetics, and molecular markers such as gene signatures and inflammation-related profiles. Salvage radiotherapy, especially when administered early, showed improved outcomes. Genetic and imaging advances contributed to improved risk stratification. The recurrence of prostate cancer after RP is influenced by surgical, biological, and individual patient factors. Early detection and risk-adapted interventions are crucial in improving survival and minimizing progression..
Ahlberg, M., Garmo, H., Adami, H., Andrén, O., Johansson, J., Steineck, G., … & Bill?Axelson, A. (2022). Time without psa recurrence after radical prostatectomy as a predictor of future biochemical recurrence, metastatic disease and prostate cancer death: a prospective scandinavian cohort study. BMJ Open, 12(12), e057242. https://doi.org/10.1136/bmjopen-2021-057242
Aldakheel, F., Alnajran, H., Alduraywish, S., Mateen, A., Alqahtani, M., & Syed, R. (2025). Analysing dna methylation and transcriptomic signatures to predict prostate cancer recurrence risk. Discover Oncology, 16(1). https://doi.org/10.1007/s12672-025-01833-8
Asuncion, A., Walker, P., Bertaut, A., Blanc, J., Labarre, M., Martin, É., … & Cochet, A. (2022). Prediction of prostate cancer recurrence after radiation therapy using multiparametric magnetic resonance imaging and spectroscopy: assessment of prognostic factors on pretreatment imaging. Quantitative Imaging in Medicine and Surgery, 12(12), 5309-5325. https://doi.org/10.21037/qims-22-184
Bejrananda, T. and Pliensiri, P. (2023). Prediction of biochemical recurrence after laparoscopic radical prostatectomy. BMC Urology, 23(1). https://doi.org/10.1186/s12894-023-01350-2
Cai, Y., Lin, J., Wang, Z., Ma, Y., Pan, J., Liu, Y., … & Zhao, Z. (2022). Identification and validation of a lipid metabolism gene signature for predicting biochemical recurrence of prostate cancer after radical prostatectomy. Frontiers in Oncology, 12. https://doi.org/10.3389/fonc.2022.1009921
Classon, J., Zamboni, M., Engblom, C., Alkass, K., Mantovani, G., Pou, C., … & Frisén, J. (2022). Prostate cancer disease recurrence after radical prostatectomy is associated with hla type and local cytomegalovirus immunity. Molecular Oncology, 16(19), 3452-3464. https://doi.org/10.1002/1878-0261.13273
Falagario, U., Abbadi, A., Remmers, S., Björnebo, L., Bogdanovi?, D., Martini, A., … & Wiklund, P. (2023). Biochemical recurrence and risk of mortality following radiotherapy or radical prostatectomy. Jama Network Open, 6(9), e2332900. https://doi.org/10.1001/jamanetworkopen.2023.32900
Guerra, A., Caseiro?Alves, F., Maes, K., Maio, R., Villeirs, G., & Mouriño, H. (2023). Risk biomarkers for biochemical recurrence after radical prostatectomy for prostate cancer using clinical and mri-derived semantic features. Cancers, 15(21), 5296. https://doi.org/10.3390/cancers15215296
Guo, H., Zhang, L., Shao, Y., An, K., Hu, C., Liang, X., … & Wang, D. (2024). The impact of positive surgical margin parameters and pathological stage on biochemical recurrence after radical prostatectomy: a systematic review and meta-analysis. Plos One, 19(7), e0301653. https://doi.org/10.1371/journal.pone.0301653
Hikita, K., Honda, M., Shimizu, R., Teraoka, S., Kimura, Y., Yumioka, T., … & Takenaka, A. (2022). Influence of the time interval between biopsy and surgery on the biochemical recurrence after robot-assisted radical prostatectomy in japanese patients. Asian Journal of Surgery, 45(11), 2179-2184. https://doi.org/10.1016/j.asjsur.2021.10.022
Jiang, J., Chen, L., Ji, X., Zheng, X., Hong, J., Tang, K., … & Zheng, X. (2023). (18f)-psma-1007pet/ct in patients with biochemical recurrence after radical prostatectomy: diagnostic performance and impact on treatment management. Research in Diagnostic and Interventional Imaging, 5, 100021. https://doi.org/10.1016/j.redii.2022.100021
Kryvenko, O., Iakymenko, O., Guido, L., Bhattu, A., Merhe, A., Mouzannar, A., … & Gonzalgo, M. (2021). Prostatic ductal adenocarcinoma controlled for tumor grade, stage, and margin status does not independently influence the likelihood of biochemical recurrence in localized prostate cancer after radical prostatectomy. Archives of Pathology & Laboratory Medicine, 146(8), 1012-1017. https://doi.org/10.5858/arpa.2021-0048-oa
Li, C., Zhu, J., Du, H., & Liang, C. (2022). Identification of novel pyroptosis-related gene signatures to predict prostate cancer recurrence. Frontiers in Oncology, 12. https://doi.org/10.3389/fonc.2022.814912
Liang, Z., Lin, S., Lai, H., Li, L., Wu, J., Zhang, H., … & Fang, C. (2023). Efficacy and safety of salvage radiotherapy combined with endocrine therapy in patients with biochemical recurrence after radical prostatectomy: a systematic review and meta-analysis of randomized controlled trials. Frontiers in Oncology, 12. https://doi.org/10.3389/fonc.2022.1093759
Luo, C., He, S., Zhang, H., He, S., Qi, H., & Wei, A. (2022). Clinical and biological significance of dna methylation-driven differentially expressed genes in biochemical recurrence after radical prostatectomy. Frontiers in Genetics, 13. https://doi.org/10.3389/fgene.2022.727307
Luo, R., Chen, Y., Ran, K., & Jiang, Q. (2020). Effect of obesity on the prognosis and recurrence of prostate cancer after radical prostatectomy: a meta-analysis. Translational Andrology and Urology, 9(6), 2713-2722. https://doi.org/10.21037/tau-20-1352
Mapelli, P., Ghezzo, S., Pini, C., Gajate, A., Spataro, A., Bezzi, C., … & Picchio, M. (2023). Predictors of psma pet positivity: analysis in a selected cohort of biochemical recurrence prostate cancer patients after radical prostatectomy. Cancers, 15(18), 4589. https://doi.org/10.3390/cancers15184589
Meguro, S., Haga, N., Imai, H., Yoshida, Y., Takinami-Honda, R., Matsuoka, K., … & Kojima, Y. (2021). Association between surgical stress and biochemical recurrence after robotic radical prostatectomy. JSLS Journal of the Society of Laparoscopic & Robotic Surgeons, 25(1), e2020.00078. https://doi.org/10.4293/jsls.2020.00078
Miyazaki, Y., Goto, T., Li, X., Nakayama, K., Okasho, K., Takeda, M., … & Inoue, T. (2022). Up?regulation of secretory leukocyte protease inhibitor in human samples might have a potential role of predicting prostate cancer recurrence and progression after surgery and hormonal therapy. Cancer Medicine, 12(3), 3328-3342. https://doi.org/10.1002/cam4.5134
Perennec, T., Vaugier, L., Tolédano, A., Scher, N., Thomin, A., Pointreau, Y., … & Supiot, S. (2021). Stereotactic re-irradiation for local recurrence after radical prostatectomy and radiation therapy: a retrospective multicenter study. Cancers, 13(17), 4339. https://doi.org/10.3390/cancers13174339
Roberts, M., Chatfield, M., Hruby, G., Nandurkar, R., Roach, P., Watts, J., … & Emmett, L. (2022). Event?free survival after radical prostatectomy according to prostate?specific membrane antigen?positron emission tomography and european association of urology biochemical recurrence risk groups. British Journal of Urology, 130(S3), 32-39. https://doi.org/10.1111/bju.15762
Siech, C., Wenzel, M., Lange, C., Garcia, C., Humke, C., Tian, Z., … & Mandel, P. (2024). The association between patient characteristics and biochemical recurrence after radical prostatectomy. Medicina, 60(7), 1119. https://doi.org/10.3390/medicina60071119
Singh, M., Kathuria, S., Jain, S., Rasool, S., Tyagi, V., Gupta, M., … & Sharma, A. (2022). Evaluation of biochemical recurrence and correlation with various parameters after robotic-assisted radical prostatectomy: a single center experience. Indian Journal of Surgical Oncology, 13(3), 661-667. https://doi.org/10.1007/s13193-022-01554-2
Yang, C., Wang, H., Hassouna, M., Chand, M., Huang, W., & Chung, H. (2021). Prediction of a positive surgical margin and biochemical recurrence after robot-assisted radical prostatectomy. Scientific Reports, 11(1). https://doi.org/10.1038/s41598-021-93860-y
Zhang, C., Zhang, Y., Niu, N., & Fu, G. (2023). Predictive value of preoperative prostate health index and serum testosterone testing for biochemical recurrence after radical prostatectomy for non-metastatic prostate cancer. Archivos Españoles De Urología, 76(10), 787. https://doi.org/10.56434/j.arch.esp.urol.20237610.95
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