Consistent with prior reports, our study found that BrM from PC predominantly occurred in patients presenting with high-risk features such as elevated PSA levels at diagnosis, advanced Gleason scores, PNI, castrate resistance, and synchronous metastases in other organs.5–7,10,16 Furthermore, the median interval between PC diagnosis and BrM detection—47.8 months—parallels findings from other studies.5,6,14,17,18 This pattern underscores the potential need for targeted BrM screening strategies at a certain time point in patients with these high-risk features. The gene discussed is KLK3; the disease is pachyonychia congenita.