Should Grade Group 1 (GG1) Be Called Cancer?

Overview

Journal World J Urol

Specialty Urology

Date 2021 Jan 12

PMID 33432506

Citations 6

Authors

Craig V Labbate

Gladell P Paner

Scott E Eggener

Affiliations

Soon will be listed here.

Abstract

Introduction: 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.

Methods: Evidence-based review identifying arguments for and against Grade Group 1 being referred to as cancer.

Results: 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.

Discussion: 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.

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