In studies by Kanehira et al. (n = 113) and Shindo et al. (n = 96), elevated preoperative PSA levels (>20 ng/mL), Gleason pattern 5, and positive surgical margins were identified as independent predictors of biochemical recurrence following radical prostatectomy in high-risk prostate cancer patients. This evidence concerns the gene KLK3 and Familial prostate cancer.