Kim DW, Chen MH, Wu J, et al. - The present study was conducted to examine prostate‐specific antigen levels of ≤ 4 and > 4 ng/ml and risk of prostate cancer–specific mortality in men with biopsy gleason score 9 to 10 prostate cancer. Researchers enrolled a total of 17,632 men with clinical T1-4 prostate cancer with a biopsy Gleason score (GS) of 6 to 10 who had undergone radical prostatectomy at a single academic center between February 25, 1992, and February 25, 2016. It has been reported that some men with prostate-specific antigen ≤ 4 ng/mL and a biopsy GS of 9 to 10 may have pathologic or genetic variants that make them less amenable to a cure with current standards of care. There is a need for additional workup to assess small cell, neuroendocrine, and genetic variants.