Zhang AY, et al. – Given the surplus of individual candidate biomarkers proposed for predicting PSA relapse in localized prostate cancer (PCa), researchers re-analyzed these biomarkers for PSA relapse, metastatic relapse, and PCa death, with extended follow-up. They developed a combined prognostic model for clinical outcomes by using biomarkers of significance, which was validated in a large independent cohort. The discovery cohort (n=324) was based on 12 biomarkers with a median follow-up of 16 years. They noted a significant association of seven biomarkers with PSA relapse. Findings indicated non-adequacy of PSA relapse as a surrogate for metastasis or PCa death. In the prediction of metastasis, they observed a small benefit of the dual biomarker signature of AZGP1 and Ki67 over AZGP1 alone.