Men diagnosed with high-risk (biopsy Gleason sum 8–10 or serum PSA level >20 ng/ mL or clinical stage ≥T3) and very-high-risk (VHR; primary Gleason pattern 5 on biopsy or ≥5 biopsy cores containing Gleason sum 8–10 or multiple individual NCCN high-risk features) PCa who chose RP with pelvic lymphadenectomy or RT+ADT from 2004 to 2013; in a MDPCC. This evidence concerns the gene KLK3 and posterior cortical atrophy.