BCR and neoplasm: Taking into account the paucity of evidence of this heterogeneity in terms of BCR-free survival and the fact that Gleason grade is the feature that more accurately and more clearly reflects tumor aggressiveness (27), patients with GS ≥ 8 (even as a single D'Amico high-risk factor) should not be considered as a favorable subgroup, especially when the Gleason pattern 5 is present.