Defining prostate cancer with lethal biology based upon clinical criteria ischallenging.Locally advanced/High-Grade prostate cancer can be downstaged or even downgraded with cure in up to 60％ of patients with primary therapy.1-5 However, what is known is that high-grade prostate cancers have a greater potential for recurrence and progression to metastatic disease, which can ultimately result in a patient\'s death.Patients with clinical features of “high-risk” prostate cancer (cT2c, PSA ＞20, ≥ Gl 8 on biopsy) are more likely to harbor more aggressive pathologicfindings.