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Should Grade Group 1 (GG1) be called cancer?
Craig V Labbate1, Gladell P Paner2, Scott E Eggener3
1Section of Urology, Department of Surgery, University of Chicago Medicine, Chicago, IL, USA.
World Journal of Urology
|January 12, 2021
Summary
ISUP Grade Group 1 prostate cancer exhibits an indolent course, similar to non-cancerous lesions. Renaming this low-grade prostate cancer could reduce overtreatment and patient anxiety.
Area of Science:
- Oncology
- Urologic Pathology
Background:
- ISUP Grade Group 1 represents the least aggressive form of prostate cancer.
- The clinical behavior of Grade Group 1 is notably indolent.
- Renaming low-grade cancers has historical precedent in other malignancies.
Purpose of the Study:
- To review arguments for and against classifying ISUP Grade Group 1 as cancer.
- To evaluate the clinical and genomic characteristics of Grade Group 1 prostate cancer.
Main Methods:
- Evidence-based literature review.
- Analysis of histologic, genomic, and clinical outcome data for Grade Group 1 prostate cancer.
Main Results:
- Grade Group 1 shows minimal microinvasion and extraprostatic extension.
- Genomic profiles partially overlap with Grade Group 2 but differ significantly from Grade Group 3+.
- No metastatic potential is documented; active surveillance and treatment yield excellent outcomes.
Conclusions:
- Despite histologic signs of neoplasia, Grade Group 1 behaves indolently, resembling precursor lesions.
- Renaming ISUP Grade Group 1 prostate cancer may mitigate overtreatment, side effects, and healthcare costs.
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