In summary, this meta-analysis revealed that PGG≥3, PSM ≥3 mm, multiple PSM focality, and a higher pathologic stage of the tumor were associated with an increased risk of BCR in patients with PCa with PSM, which may also be associated with higher biological aggressiveness and should be treated differently in terms of adjunct treatment and monitoring frequency. The gene discussed is BCR; the disease is posterior cortical atrophy.