title: [Correlation between Gleason score on prostate biopsies diagnostic of adenocarcinoma and radical prostatectomy specimens].
abstract: OBJECTIVE
  We analyse the concordance between Gleason scores on prostate biopsies diagnostic of adenocarcinoma and radical prostatectomy specimens.
  
  
  METHODS
  We reviewed the charts of 214 patients who underwent radical prostatectomy between January 1992 and November 2002. We calculated the percentage of correct diagnosis, understaging and overstaging for individual Gleason and for groups with scores between 2-4, 5-6, 7 and 8-10. We performed the statistical analyses of concordance for the groups using the kappa weighted index (< 0.4 low reliability, 0.4-0.75 good reliability; > 0.75 excellent reliability).
  
  
  RESULTS
  41 patients were excluded. The percentages of right diagnosis, understaging and overstaging for the remainder 173 were 32.3%, 44% and 23.7% respectively for individual Gleason scores, and 52.6%, 32.4% and 15% respectively for grouped Gleason scores. Statistical analysis resulted in a kappa weighted index of 0.52, a result which did not vary after excluding patients treated with neoadjuvant hormonal therapy
  
  
  CONCLUSIONS
  In our series, the statistical correlation obtained for grouped Gleason scores is good. However, understaging is the biggest problem for prostate biopsies diagnostic of adenocarcinoma when compared with definitive pathologic results on the specimen. Besides, and in opposition, more than 50% of our patients deemed as less differentiated (Gleason score 7 and 8-10) presented lower grades in the specimen. Both limitations should be taken into consideration when therapeutic options are exposed to our patients.
authors.affiliation: Servicios de Urología y Anatomía-Patológica, Hospital Virgen del Camino, Pamplona, Navarra, España. mmontess@cfnavarra.es
authors.forename: Manuel
authors.initials: M
authors.lastname: Montesino Semper
authors.forename: Javier
authors.initials: J
authors.lastname: Jiménez Aristu
authors.forename: Begoña
authors.initials: B
authors.lastname: Repáraz Romero
authors.forename: Manuel
authors.initials: M
authors.lastname: Ruiz Ramo
authors.forename: Ignacio
authors.initials: I
authors.lastname: Villanueva Pérez
authors.forename: Antonio
authors.initials: A
authors.lastname: Hualde Alfaro
authors.forename: Miguel
authors.initials: M
authors.lastname: Pinós Paul
authors.forename: Alvaro
authors.initials: A
authors.lastname: De Pablo Cárdenas
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies
vernacular_title: Estudio de correlación entre las sumas de Gleason de las biopsias de próstatas con adenocarcinoma y de las piezas de prostatectomía radical.