In the subgroup analyses, for those with PSA < 4 ng/mL, FLA showed markedly worse OS and cancer-specific mortality (CSM) outcomes (OS HR = 1.89; 95%CI: 1.01–3.53; p = 0.0466 and CSM HR = 4.25; 95%CI: 1.04–17.43; p = 0.044).FLA is a promising focal therapy of PCa. The gene discussed is KLK3; the disease is posterior cortical atrophy.