Su ZT, et al. - Given a proportion of men having grade group (GG) 2 intermediate-risk (IR) prostate cancer are downgraded to GG1 or harbor favorable pathology (FP) at radical prostatectomy (RP), and potential active surveillance candidates in this group with results similar to biopsy low-risk (LR) disease may be recognized by predicting downgrading or FP, researchers undertook this comparative cohort analysis of biopsy LR and IR men who had RP at The Johns Hopkins Hospital and Bayview Medical Center between 2005 and 2018. Pathological results at RP and recurrence-free survival were assessed. Findings revealed that the observed oncologic outcomes in GG2 IR patients who experienced downgrading or harbored FP were similar to those seen in LR patients. For downgrading and for upgrading, concordance statistics for final predictive regression models were identified to be 0.76 and 0.70, respectively. Information regarding the risks of pathological downgrading/upgrading may be afforded to patients with the help of the developed models. These models, additionally, aid identification of a segment of GG2 IR patients who would consider continuing active surveillance depending on predicted probability cutoffs.