Should Gleason 6 be labeled as cancer? #MMPMID25730327
Kulac I; Haffner MC; Yegnasubramanian S; Epstein JI; De Marzo AM
Curr Opin Urol 2015[May]; 25 (3): 238-45 PMID25730327show ga
Purpose: This review covers arguments for and against removing the label of ?cancer? Gleason score 6 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. The 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 manuscript 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 based on 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.
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Curr+Opin+Urol 2015 ; 25 (3): 238-45
