To determine whether Gleason scores were concordant between prostate biopsies (bGS) and the definitive resection specimen (pGS) excised with robot-assisted radical prostatectomy (RARP); to identify clinical and pathological factors that might predict upgrading; and to evaluate how upgrading affected outcome. Between 2009 and 2016, 25 Belgian centers participated in collecting prospective data for patients that underwent RARP. We analyzed the concordance rate between the bGS and the pGS in 8021 patients with kappa statistics, and we compared concordance rates from different centers. We assessed the effect of several clinical and pathological factors on the concordance rate with logistic regression analysis. The concordance rate for the entire population was 62.9%. Upgrading from bGS to pGS occurred in 27.3% of patients. The number of biopsies was significantly associated with concordance. Older age (>60 y), a higher clinical T stage (≥cT2), a higher PSA value at the time of biopsy (>10 ng/ml), and more time between the biopsy and the radical prostatectomy were significantly associated with a higher risk of upgrading. Positive margins and PSA relapse occurred more frequently in upgraded patients. Center size did not significantly affect the concordance rate (p = 0.40).This prospective, nationwide analysis demonstrated a Gleason score concordance rate of 62.9%. Upgrading was most frequently observed in the non-concordant group. We identified clinical and pathological factors associated with (non)-concordance. Upgrading was associated with a worse oncological outcome. Center volume was not associated with pathological accuracy.

确定前列腺癌活检（bGS）和机器人辅助根治性前列腺切除术（RARP）切除的明确切除标本（pGS）之间的格里森评分是否一致；确定可能预测升级的临床和病理因素；并评估升级对结果的影响。在2009年至2016年期间，有25个比利时中心参与了接受RARP的患者的前瞻性数据。我们通过kappa统计分析了8021例患者中bGS和pGS的一致性率，并比较了不同中心的一致性率。我们通过逻辑回归分析评估了几种临床和病理因素对一致性发生率的影响。全体人口的符合率是62.9％。27.3％的患者从bGS升级到pGS。活检的数量与一致性显着相关。年龄较大（> 60岁），临床T分期较高（≥cT2），活检时的PSA值较高（> 10 ng / ml）以及活检与根治性前列腺切除术之间的时间更长，与更高的升级风险。升级患者的切缘和PSA复发率更高。中心大小并未显着影响一致性率（p  = 0.40）。这项全国性的前瞻性分析表明，格里森分数的符合率为62.9％。在非一致组中最常观察到升级。我们确定了与（不一致）相关的临床和病理因素。升级与更差的肿瘤学结果相关。中心体积与病理准确性无关。