Aim of the study: Gleason score stratification according to age at diagnosis has been retrospectively evaluated in 1028 men with biopsy-proven prostate cancer (PCa).

Material and methods: From January 2006 to December 2014, 2435 Caucasian men aged between 37 and 92 years underwent transperineal prostate biopsy for suspicion of PCa. The indications were as follows: abnormal digital rectal examination (DRE), PSA values > 10 ng/ml or between 4.1–10 or 2.6–4 ng/ml, with free/total PSA < 25% and < 20%, respectively.

Results: In 1028 (42.2%) patients with median PSA of 9.6 ng/ml a PCa was found (median age 62.3 years; range: 42–92 years); 757 (73.7%) vs. 271 (26.3%) men had a T1c vs. T2 clinical stage, respectively. Median Gleason score was 7 (range: 6–10). The Gleason score progressively increased with the age of the patients at diagnosis, and a significantly correlation between Gleason score  8 and men older than 80 years was demonstrated (p = 0.0001).

Conclusions: The detection rate of aggressiveness of PCa progressively increased with the age at diagnosis; Gleason score  8 was more frequently diagnosed in men older than 80 years with PSA values > 10 ng/ml (about 80% of the cases) and abnormal DRE (about 60% of the cases).