Considering the strengths and limitations of each biomarker, an integrative approach combining PSA, exosomal miRNAs, and ctDNA may offer the most accurate and personalized strategy for post-radical prostatectomy surveillance.[19] Exosomal miRNAs provide high specificity and biological stability, potentially reducing the false positives frequently encountered with PSA alone.[20] Concurrently, ctDNA offers insights into tumor dynamics, including mutational profiles and emerging resistance mechanisms, which can inform treatment selection and prognostication.[21]. This evidence concerns the gene KLK3 and neoplasm.