1. Should Grade Group 1 (GG1) be called cancer?
- Author
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Craig Labbate, Gladell P. Paner, and Scott E. Eggener
- Subjects
Nephrology ,Oncology ,medicine.medical_specialty ,Patient anxiety ,business.industry ,Urology ,030232 urology & nephrology ,Cancer ,Histology ,medicine.disease ,Natural history ,Thyroid carcinoma ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Extraprostatic extension ,business - Abstract
ISUP Grade Group 1 prostate cancer is the lowest histologic grade of prostate cancer with a clinically indolent course. Removal of the term ‘cancer’ has been proposed and has historical precedent both in urothelial and thyroid carcinoma. Evidence-based review identifying arguments for and against Grade Group 1 being referred to as cancer. Grade Group 1 has histologic evidence of tissue microinvasion and 0.3–3% rate of extraprostatic extension. Genomic evaluation suggests overlap of a minority of Grade Group 1 cancers with those of Grade Group 2. Conversely, Grade Group 1 tumors appear to have distinct genetic and genomic profiles from Grade Group 3 or higher tumors. Grade Group 1 has no documented ability for regional or distant metastasis and long-term follow up after treatment or active surveillance is safe with excellent oncologic outcomes. Grade Group 1 prostate cancer, while showing evidence of neoplasia on histology has a remarkably indolent natural history more akin to non-neoplastic precursor lesions. Consideration should be given to renaming Grade Group 1 prostate cancer, which has the potential to minimize overtreatment, treatment-related side effects, patient anxiety, and financial burden on the healthcare system.
- Published
- 2021
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