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Widespread use of testing for prostate-specific antigen (psa) has led to a migration in the stage and grade of prostate cancer (pca), with most men presenting with localized disease. However, 20%-35% of patients still present with high-risk disease (psa > 20 ng/mL, biopsy Gleason score 8-10, or clinical stage T3). Despite advances in various treatment modalities, patients with high-risk disease have a significant chance of recurrence and death after surgery, often because of the presence ofdoi:10.3747/co.v17i0.677 fatcat:owo6jbalczfahdnrt67gauyuy4