Outcome after radical prostatectomy with a pretreatment prostate biopsy Gleason score of ≥8

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Abstract
The use of radical prostatectomy to treat patients with high‐grade prostate cancer is the subject of much discussion, and the authors from Miami present their considerable experience in this field. They show that patients with a pre‐treatment biopsy of Gleason score of ≥8 may benefit from radical prostatectomy, assuming a clinical stage of T1–T2, and particularly if their PSA level is P < 0.001), the presence of EPE (4.2, 1.6–10.9, P = 0.004) and a positive surgical margin (3.8, 1.5–9.7, P = 0.005) were significant independent predictors in a multivariate analysis. CONCLUSION RP is a reasonable treatment option for patients with a prostate biopsy GS of ≥8 and clinical stage T1–2. These patients have a high chance of remaining disease‐free if their PSA level is ≤ 20 ng/mL. Patients with a pretreatment biopsy GS of ≥ 8 should be counselled about the potential differences between the biopsy and the RP specimen GS.