The impact of time from biopsy to radical prostatectomy on Gleason score undergrading and other related factors

Introduction Gleason score biopsy undergrading (GSBU) can have an impact on the management and prognosis of patients with Prostate Cancer (PC). We analyze the possible impact of time and other clinical and analytical factors in the appearance of GSBU in our series. Patients and method Ambispective, multicenter study of 1955 patients with localized PC undergoing radical prostatectomy (RP) between 2005 and 2018. Descriptive statistics and hypothesis testing are reported by univariate and multivariate analyses. Results Mean age 63.69 (44–80) years, median PSA 8.70 ng / ml (1.23–99). GSBU was observed in 34.7% of the entire cohort. In 72.8% of the cases, the GSBU occurred in one consecutive Gleason score, with the progression from 3 + 3 to 3 + 4 being the most frequent (289 patients, 47.6%). Performing RP 90–180 days before or after the biopsy does not have an impact on its undergrading in any of the groups. In the univariate and multivariate analysis, the presence of tumor or pathological rectal examination in both lobes, the tumor load ≥50% of cylinders and a DPSA ≥ 0.20, showed independent discriminative capacity to select patients who presented GSBU. Conclusions The time from biopsy to RP did not show impact on GSBU. The number of affected cylinders, bilateral tumor and DPSA are easily accessible parameters that can help us select patients with greater probability of presenting GSBU.