TY - JOUR
T1 - Should Gleason 6 be labeled as cancer?
AU - Kulac, Ibrahim
AU - Haffner, Michael C.
AU - Yegnasubramanian, Srinivasan
AU - Epstein, Jonathan I.
AU - De Marzo, Angelo M.
N1 - Publisher Copyright:
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2015/5/27
Y1 - 2015/5/27
N2 - Pupose of review The review covers arguments for and against removing the label of 'cancer' in Gleason score 6 prostate tumors. Recent findings 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. Summary 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.
AB - Pupose of review The review covers arguments for and against removing the label of 'cancer' in Gleason score 6 prostate tumors. Recent findings 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. Summary 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.
KW - Gleason score
KW - active surveillance
KW - prostate cancer
UR - http://www.scopus.com/inward/record.url?scp=84928569631&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84928569631&partnerID=8YFLogxK
U2 - 10.1097/MOU.0000000000000165
DO - 10.1097/MOU.0000000000000165
M3 - Review article
C2 - 25730327
AN - SCOPUS:84928569631
SN - 0963-0643
VL - 25
SP - 238
EP - 245
JO - Current opinion in urology
JF - Current opinion in urology
IS - 3
ER -