KLK3 and Familial prostate cancer: Pound et al (1999) showed that patients initially described by Walsh (1994) who develop a PSA recurrence after surgery develop metastasis over a median time of 8 years. Zincke et al (1994) compared PSA recurrence rates, cause-specific mortality and overall survival among 3170 patients treated with surgery and found strong and consistent correlations between these outcome variables and grade, stage and PSA level. D'Amico et al (2003) further showed that higher rates of PSA rise after surgery or radiation was associated with earlier prostate cancer-specific death.