Verhoef EI, et al. - The objective of the current study was to compare the clinicopathologic qualities and outcome of men with overall biopsy Gleason score (GS) 3+4=7 with highest GS 3+4=7 (HI=OV) to those with highest GS > 3+4=7 (HI>OV). Based on these outcomes, patients with the highest GS >3+4=7 had worse clinicopathologic features among patients with overall GS 3+4=7. However, the clinical outcome was not statistically significant. Therefore utilization of overall GS instead of highest GS for clinical decision-making is justified, potentially preventing overtreatment in prostate cancer patients.