While pure GP3 has minimal metastatic potential, it is unclear whether GP3 quantity in the presence of GP4 and GP5 affects oncological outcomes.<h4>Objective</h4>To assess the predictive value of PCa biopsy GP lengths on long-term metastasis-free survival (MFS).<h4>Methods</h4>Prostate biopsies of 1,881 men with screen-detected PCa who participated in the Dutch part of the European Randomized Study of Screening for Prostate Cancer (ERSPC) between 1993 and 2007 were revised for GP 3-5 length. This evidence concerns the gene GP5 and posterior cortical atrophy.