The purpose of this study was to examine the relationship between the zonal origin of anterior dominant prostate tumors and the clinical outcome after radical prostatectomy. After radical prostatectomy, researchers studied the clinical outcomes of 197 individuals with well-characterized anterior dominant prostatic cancers. They utilized univariate Cox proportional hazards models to assess whether tumors in the anterior peripheral zone (PZ) or transition zone (TZ) were associated with worse outcomes. Nearly half (97/197) of all cancers originated in the anterior PZ, whereas 36% came from the TZ, 7% came from both zones, and 8% originated in an ambiguous zone. No statistically significant differences were seen between tumors in the anterior PZ and TZ tumors concerning grade, extraprostatic extension, or surgical margin positivity. Biochemical recurrence (BCR) occurred in 19 patients (9.6%), 10 of whom had an anterior PZ origin and 5 of whom had a TZ origin. The average duration of follow-up for individuals who did not develop BCR was 9.5 years (IQR 7.2, 12.7). The 5-year and 10-year BCR-free survival rates for anterior PZ tumors were 91% and 89%, respectively, whereas those for TZ tumors were 94% and 92%. There was no significant difference in time to BCR between the anterior PZ and the TZ tumor zone of origin using univariate analysis (P=0.5). BCR-free survival for a long period of time was not significantly related to the zone of origin in this anatomically well-characterized cohort of anterior dominant prostate tumors. Separating anterior and posterior PZ localization in future investigations that use the zone of origin as a parameter may produce different results.