The primary and unique observation of our article is that pathological Gleason 6 cancers rarely, if ever, metastasize at the time of radical prostatectomy (RP). The editorial comment raises minor methodological issues that are typically raised by reviewers and not in an editorial comment. Nevertheless, we feel compelled to respond. The comment is made that our study used biochemical recurrence (BCR) as a surrogate for the propensity of Gleason 6 cancers to metastasize, as compared to a study by Ross et al, which examined whether pathological Gleason 6 tumors are associated with lymph node metastasis. The 2 studies utilize different endpoints and were asking different questions. This is clearly stated in our discussion.
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