Butler SS, Dee EC, Lamba N, et al. - Using data from a large, national randomized controlled trial, researchers sought to validate the clinical subclassification of high-risk prostate cancer into favorable and standard risk classes. Three thousand thirty-three men from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial were identified who had been diagnosed from 1993 to 2001 with clinically localized prostate cancer—either intermediate-risk disease (clinical stage T2b-c, a Gleason score of 7, or a prostate-specific antigen [PSA] level of 10 to 20 ng/mL) or high-risk disease (clinical stage T3-T4, a Gleason score of 8-10, or a PSA level > 20 ng/mL)—that was managed with radical prostatectomy or radiation therapy. Data reported that the median follow-up was 5.7 years. In a prospectively collected patient cohort, this research validates the prognostic utility of a subclassification for high-risk disease. Patients with favorable high-risk disease have prostate cancer-specific mortality similar to that of intermediate-risk disease patients, and significantly better than that of standard high-risk disease patients.