TP53 and pachyonychia congenita: There is increasing evidence that metastatic relapse (MR) is a more accurate surrogate for PC specific survival than biochemical relapse (BCR).10 Recent work from our own group has shown that markers clearly associated with biochemical recurrence do not necessarily translate into markers of MR with more mature follow-up.11 In this cohort, p53 nuclear accumulation correlates with biochemical recurrence after radical prostatectomy (RP) as described by our group more than 15 years ago.12 With longer follow-up, we aimed to examine whether p53 could also predict MR and PC specific survival.