Cheng A, Zhao S, FitzGerald LM, et al. - On the basis of a previously published panel of 23 gene transcripts that differentiated patients with metastatic progression, researchers made a prediction model using independent training and testing datasets in order to create additional tools for accurate prognostication of tumor aggressiveness in prostate cancer (PCa). Thirteen out of 23 previously recognized gene transcripts that stratified individuals with aggressive PCa were verified in the training dataset. In comparison with those without recurrence in the testing dataset, these biomarkers and Gleason score (GS) were used to create a four-gene (CST2, FBLN1, TNFRSF19, and ZNF704) transcript (4GT) score that was significantly greater in individuals who grew to metastatic-lethal events. The 4GT score gave higher prognostication exactitude vs GS alone, and it enhanced risk stratification in subgroups defined by a combination of clinicopathological characteristics (ie, Cancer of the Prostate Risk Assessment-Surgery). Therefore, in men treated for localized PCa, this verified 4GT score had prognostic value for metastatic-lethal progression and assured an additional assessment for its clinical use.