Recent advancements in personalized management of prostate cancer biochemical recurrence after radical prostatectomy.

IF 2.2 3区医学 Q2 UROLOGY & NEPHROLOGY

Current Opinion in Urology Pub Date : 2025-09-01 Epub Date: 2025-05-14 DOI:10.1097/MOU.0000000000001305

Fabian Falkenbach, Jonas Ekrutt, Tobias Maurer

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Abstract

Purpose of review: Biochemical recurrence (BCR) after radical prostatectomy exhibits heterogeneous prognostic implications. Recent advancements in imaging and biomarkers have high potential for personalizing care.

Recent findings: Prostate-specific membrane antigen imaging (PSMA)-PET/CT has revolutionized the BCR management in prostate cancer by detecting microscopic lesions earlier than conventional staging, leading to improved cancer control outcomes and changes in treatment plans in approximately two-thirds of cases. Salvage radiotherapy, often combined with androgen deprivation therapy, remains the standard treatment for high-risk BCR postprostatectomy, with PSMA-PET/CT guiding treatment adjustments, such as the radiation field, and improving progression-free survival. Advancements in biomarkers, genomic classifiers, and artificial intelligence-based models have enhanced risk stratification and personalized treatment planning, resulting in both treatment intensification and de-escalation.

Summary: While conventional risk grouping relying on Gleason score and PSA level and kinetics remain the foundation for BCR management, PSMA-PET/CT, novel biomarkers, and artificial intelligence may enable more personalized treatment strategies.

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根治性前列腺切除术后前列腺癌生化复发的个体化治疗进展。

综述目的：根治性前列腺切除术后的生化复发（BCR）表现出不同的预后意义。成像和生物标志物的最新进展为个性化护理提供了巨大的潜力。最近发现：前列腺特异性膜抗原成像(PSMA)-PET/CT通过比常规分期更早地检测显微病变，彻底改变了前列腺癌的BCR管理，改善了癌症控制结果，并改变了大约三分之二的病例的治疗计划。补救性放疗通常联合雄激素剥夺治疗，仍然是高风险BCR前列腺切除术后的标准治疗方法，PSMA-PET/CT指导治疗调整，如放疗领域，提高无进展生存期。生物标记物、基因组分类器和基于人工智能的模型的进步增强了风险分层和个性化治疗计划，导致治疗强化和降级。摘要：虽然基于格里森评分、PSA水平和动力学的传统风险分组仍然是BCR管理的基础，但PSMA-PET/CT、新型生物标志物和人工智能可以实现更个性化的治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Urology 医学-泌尿学与肾脏学

CiteScore

5.00

自引率

4.00%

发文量

140

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Urology delivers a broad-based perspective on the most recent and most exciting developments in urology from across the world. Published bimonthly and featuring ten key topics – including focuses on prostate cancer, bladder cancer and minimally invasive urology – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.