Should Gleason 6 be labeled as cancer?

Current Opinion in Urology
Ibrahim KulacAngelo M De Marzo

Abstract

The review covers arguments for and against removing the label of 'cancer' in Gleason score 6 prostate tumors. While there are a number of factors that determine whether men elect active surveillance, the most powerful predictor remains the Gleason score. Gleason grading remains a robust and powerful predictor of outcome in patients with prostate cancer. A pure Gleason score 6 (GS6) tumor is exceedingly unlikely to cause harm in the near term, and there have been discussions regarding whether the term cancer should still be applied. In this review, we update the largely clinico-pathological arguments that have led to the suggestion to remove the cancer label from GS6 tumors, and we provide counter arguments on the basis of practical matters of needle biopsy sampling, classical histopathology, and molecular biology findings. The implications are that by retaining the label of cancer and implementing the recently proposed concept of prognostic groups, with patients harboring GS6 tumors placed into the lowest category, there is still a strong rationale in support of the choice of active surveillance or watchful waiting for most patients with GS6 lesions.

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Feb 28, 2016·Biochimica Et Biophysica Acta·John R Packer, Norman J Maitland
Oct 30, 2016·International Journal of Molecular Sciences·Xavier Filella, Laura Foj
Apr 5, 2017·Current Opinion in Urology·Oleksandr N Kryvenko, Jonathan I Epstein
Apr 2, 2019·AJR. American Journal of Roentgenology·Nicholas P MeermeierFergus V Coakley
Jan 5, 2020·BJU International·Richard J BryantUNKNOWN ProtecT Study Group
Oct 8, 2019·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Feng QiGong Cheng
Jul 15, 2021·Pathology Oncology Research : POR·Mun Su ChungU-Syn Ha

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Methods Mentioned

BETA
biopsy
biopsies

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