@surftohealth88 I have seen it go both ways. An acquaintance of mine had pre-op Gleason 4+5, downgraded to 3+4 after RARP. All his care at a center of excellence with broad experience in PC management. His surgery was complicated by incontinence (requiring an artificial sphincter) and ED (requiring a penal prosthesis) though he remains disease free with undetectable PSA now 2.5 years out from surgery. To some degree we must accept that the small amount of tissue actually sampled at biopsy will not always be 100% accurate when the entire gland can be examined. Still, the science tells us that decisions can only be made based upon the best information available, albeit imperfect. We cannot/should not examine our care under the retrospectoscope, as hindsight vision is always 20/20.