Examining the Association between ERG/PTEN Expression and Biochemical Recurrence in Prostate Cancer: A Comprehensive Meta-Analysis.

Background: ETS-related gene (ERG) rearrangement and tensin homolog (PTEN) deletion are common molecular alterations in prostate cancer. Their prognostic significance for biochemical recurrence (BCR) after radical prostatectomy is not fully understood. This study aimed to conduct a systematic review and meta-analysis to assess the association between ERG and PTEN status and BCR risk.

Methods: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library for studies on ERG/PTEN status and BCR following radical prostatectomy. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using fixed-effects and random-effects models to determine the risk associated with these biomarkers.

Results: The meta-analysis showed that ERG positivity was linked to a 35.38% increased risk of BCR (HR = 1.3538 (0.9517; 1.9256), p = 0.0920) with significant heterogeneity (I² = 69.3%, p = 0.0001). In subgroup analysis, ERG positivity was associated with increased BCR risk in both Asian (HR = 2.2538) and Caucasian (HR = 1.4387) populations. PTEN loss was associated with an 83.73% higher BCR risk (HR = 1.8373, 95% CI: 1.6469-2.0496, p < 0.0001) with low heterogeneity (I² = 16.3%, p = 0.2974).

Conclusions: Both ERG rearrangement and PTEN deletion are associated with an increased risk of BCR after radical prostatectomy. While these biomarkers may improve prognostic stratification, the prognostic value of ERG status varies across different populations, suggesting a need for personalized management strategies in prostate cancer based on molecular markers.