In conclusion, our study identified and established a novel robust IAGs (SSTR1, NFATC3, NRP1, TUBB3, IL1R1, GDF15) signature in predicting BCR for localized PCa patients following RP, which could help clinicians predict patients' recurrence-free survival (RFS) and improve the specific individualized management than original clinical parameters. Here, BCR is linked to posterior cortical atrophy.