Pathological staging and surgical margin status of radical prostatectomy specimens are the most important prognosticators for recurrence. A central review of pathological stage and surgical margin status was performed on a series of 552 radical prostatectomy specimens of patients, participating in EORTC trial 22911. Inclusion criteria of the trial were pathological stage pT3 and/or positive surgical margin at first pathology. Data of the second review were compared with those of first pathologists and related to clinical follow-up. Although a high concordance between second pathology and first pathologists existed for seminal vesicle invasion , agreement was much less for extraprostatic extension and for surgical margin status. Second pathology of surgical margin status was a stronger predictor of biochemical progression-free survival in univariate analysis [hazard ratio than first pathology. The second pathology demonstrated a significant difference between those with and without extraprostatic extension, while first pathology failed to do so. The observations suggest that review of pathological stage and surgical margin of radical prostatectomy strongly improves their prognostic impact in multiinstitutional studies or trials.