Impact of liquid biopsies on early detection, monitoring, and prognostication in prostate cancer: A meta-analysis of emerging evidence.

32 Background: Prostate cancer remains a leading cause of cancer-related morbidity and mortality among men worldwide. Traditional diagnostic and monitoring techniques often lack sensitivity and specificity, particularly in early stages. Liquid biopsies, which analyze circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) from blood samples, have emerged as a promising non-invasive alternative for early detection, monitoring disease progression, and prognostication in prostate cancer. Methods: The PubMed, Embase, Scopus and Cochrane databases were systematically searched from inception until June 2024 using relevant keywords. We analyzed the pooled data as untransformed proportions with 95% confidence intervals (CI) using Random Effects model in OpenMeta (version 5.3). The I 2 and X 2 statistics were used to evaluate inter-study heterogeneity. An I 2 value of >50% was considered significant heterogeneity. Subgroup analyses were performed to assess the diagnostic accuracy, prognostic value, and clinical utility of CTCs and ctDNA. Results: A total of 30 studies involving 5,200 prostate cancer patients were included in the meta-analysis. Liquid biopsies demonstrated a pooled sensitivity of 85% (95% CI: 80%-90%) and a specificity of 88% (95% CI: 83%-92%) for early detection of prostate cancer. CTCs and ctDNA levels were significantly correlated with tumor burden, Gleason score, and metastatic potential. Furthermore, elevated levels of CTCs and ctDNA were associated with poorer overall survival and progression-free survival, underscoring their prognostic value. Conclusions: Liquid biopsies offer a robust, non-invasive method for the early detection, monitoring, and prognostication of prostate cancer. This meta-analysis highlights their potential to improve clinical outcomes through timely and accurate disease management. Future research should focus on standardizing methodologies and integrating liquid biopsies into routine clinical practice.