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Does true Gleason pattern 3 merit its cancer descriptor?

Saiful Miah¹, Hashim U Ahmed¹, Alex Freeman²

¹Division of Surgery and Interventional Science, University College London Medical School Building, 21 University Street, London WC1E 6AU, UK.

Nature Reviews. Urology

|August 18, 2016

Summary

The Gleason score 3 + 3 = 6 prostate cancer diagnosis is being re-evaluated for clinical significance. Research questions if this low-grade disease impacts patient quality of life and if treatment harms outweigh benefits.

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Area of Science:

Urology
Oncology
Pathology

Background:

The Gleason grading system is a long-standing tool for prostate cancer prognostication.
A growing debate questions the clinical significance of Gleason score 3 + 3 = 6 prostate cancer.

Purpose of the Study:

To evaluate whether Gleason score 3 + 3 = 6 prostate cancer affects patient morbidity and quality of life.
To consider modifications in prostate cancer classification for Gleason score 3 + 3 = 6 disease.

Main Methods:

Review of clinical, molecular, and genetic research.
Analysis of the impact of Gleason score 3 + 3 = 6 disease on patient outcomes.
Assessment of treatment consequences for Gleason score 3 + 3 = 6 prostate cancer.

Main Results:

Gleason score 3 + 3 = 6 prostate cancer is under scrutiny for its clinical significance.
Research is exploring the potential impact of this low-grade disease on quality of life.
Treatments for Gleason score 3 + 3 = 6 disease can lead to significant patient harm.

Conclusions:

The clinical significance of Gleason score 3 + 3 = 6 prostate cancer requires further investigation.
Potential modifications to prostate cancer classification, possibly removing the 'cancer' label for Gleason 3 + 3 = 6, may be warranted.
The morbidity associated with treating Gleason score 3 + 3 = 6 disease necessitates careful consideration.