[Evidence of the radical prostatectomy Gleason score in the biopsy Gleason score].

INTRODUCTION The Gleason score (Gs) for prostatic cancer has a good prognosis correlation after radical prostatectomy, for this reason its correlation with the Gs in the biopsy can be useful. PATIENTS AND METHODS Two hundred fifteen patients with blind evaluation among three pathologists of their Gs in biopsy and in the corresponding radical prostatectomy specimen are presented. RESULTS The exact coincidence is present in 49.7% of cases, 38.6% of cases are under graded in the biopsy and 11.6% of them over graded in the biopsy. No cases of Gs 2 in the biopsy are found. Any case with Gs 3 and 4 in the biopsy are reproduced in the radical prostatectomy specimen. The exact coincidence for biopsy Gs 5, 6, 7, 8 and 9 are 25%, 45%, 72.7%, 36.6% and 60% respectively (kappa 0.32 +/- 0.047, p<0.0001 in Gs 5 to 8). The Gleason pattern 4 is the less diagnosed in prostate biopsies [40% of cases with this pattern in the excision specimen it is missing in the biopsy). CONCLUSIONS The Gs in the needle prostatic biopsy has a good correspondence with the Gs in the radical prostatectomy specimen. For an increase of the reproducibility it is recommendable avoid the diagnosis of Gs 2, 3 and 4 in biopsy and a scrupulous search for the patterns 4 and 5.