sentence: In order to improve disease control in such ‘ very ’ high ‐ risk cases , combinational approaches will be needed 7 , 8.Most risk stratification schemes place men at high risk of progression if high ‐ grade PC ( HGPC ) , designated by pathological Gleason sum ≥ 8, is identified in diagnostic biopsy and / or prostatectomy specimens 1 , 2 , 3 , 9 .