According to the National Comprehensive Cancer Network (NCCN) guidelines, high-risk prostate cancer (PCa) is characterized by initial prostate-specific antigen levels (PSA) >20 ng/mL, Gleason grade (GG) ≥4 according to the International Society of Urologic Pathology (ISUP) 2014 guidelines [1], or clinical T stage ≥T3 [2]. Here, KLK3 is linked to posterior cortical atrophy.