Predictive factors associated with Gleason score underestimation on prostate biopsy in a monocentric cohort of 3,062 patients treated by mini-invasive radical prostatectomy.

113 Background: Gleason score (GS) on prostate biopsy is a critical factor in the initial evaluation of patients with prostate cancer (PC), and can lead to different therapeutic options. However, it may differ from the final pathologic result on radical prostatectomy (RP) specimen in up to 30 to 50% of cases. The aim of this study was to explore the clinicopathological features and outcomes associated with Gleason upgrading from biopsy to RP in a contemporary cohort and to develop an upgrading risk tool available preoperatively. Methods: Using a monocentric prospectively maintained database, we included 3,062 patients who underwent minimally invasive RP between 2005 and 2012. All biopsies and surgical specimens were analyzed by dedicated pathologists. We explored clinicopathological features and outcomes associated with Gleason upgrading from biopsy to RP. A multivariate logistic regression was used to develop a nomogram predicting upgrading for Gleason 6 PC. Results: The median number of biopsy cores was...