However, prostate cancer patients without the CYP11A1 (tttta)4 allele had an increased risk of metastatic disease and increased risk of high-grade disease on biopsy (Gleason grade 8 or higher) when compared to prostate cancer patients with the CYP11A1 (tttta)4 allele (Kumazawa et al. 2004). Here, CYP11A1 is linked to metastatic neoplasm.