Verep S, et al. - In patients who were eligible for active surveillance (AS), a treatment alternative in low-risk prostate cancer (PCa), researchers intended to examine the pathological upgrading following radical prostatectomy (RP). There were 627 patients who underwent RP between August 2006 and July 2017. Study participants included 136 patients who were eligible for AS at the time of RP. Results indicated that 12.5% of patients were upstaged to pT3a disease with a possible risk of Gleason 4 pattern, so tumor upgrading should be cautiously considered before offering AS to low-risk PCa patients. Multivariate analysis showed that Gleason upgrading was independently associated with perineural invasion and pathologic T stage.