KLK3 and pachyonychia congenita: Clinical decision continues to depend upon serum prostate-specific antigen (PSA) levels, tumor stage, risk classes, and pathologic Gleason score (GS).[1] Although patients with GS 6/ISUP grade 1 PC have excellent outcomes, those with GS ≥7/ISUP grade ≥2 can have variable results from therapies.