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.

确定前列腺活检 (bGS) 和机器人辅助根治性前列腺切除术 (RARP) 切除的最终切除标本 (pGS) 之间的格里森评分是否一致；识别可能预测升级的临床和病理因素；并评估升级如何影响结果。 2009 年至 2016 年间，25 个比利时中心参与收集接受 RARP 的患者的前瞻性数据。我们通过 kappa 统计分析了 8021 名患者的 bGS 和 pGS 之间的一致率，并比较了不同中心的一致率。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率的影响。总人口的一致率为62.9%。 27.3% 的患者从 bGS 升级为 pGS。活检的数量与一致性显着相关。年龄较大（>60 岁）、较高的临床 T 分期（≥cT2）、活检时较高的 PSA 值（>10 ng/ml）以及活检与根治性前列腺切除术之间的时间间隔较长，与升级风险较高。升级患者中切缘阳性和 PSA 复发的发生率更高。中心规模并没有显着影响一致性率 ( p  = 0.40)。这项前瞻性全国性分析表明，格里森评分一致性率为 62.9%。升级在非一致组中最常见。我们确定了与（非）一致性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。