Genitourinary Pathology Society and International Society of Urological Pathology White Paper on Defining Indolent Prostate Cancer: Call for a Multidisciplinary Approach

IF 25.3 1区医学 Q1 UROLOGY & NEPHROLOGY European urology Pub Date : 2025-03-17 DOI:10.1016/j.eururo.2025.02.029

Rajal B. Shah, Gladell P. Paner, Liang Cheng, Angelo M. De Marzo, Cristina Magi-Galluzzi, Murali Varma, Ming Zhou, Ali Amin, Mahul B. Amin, Manju Aron, Isabela W. Cunha, Jonathan I. Epstein, Samson W. Fine, Aiman Haider, Kenneth A. Iczkowski, James G. Kench, Lakshmi Priya Kunju, Sambit K. Mohanty, Rodolfo Montironi, George J. Netto, Glen Kristiansen

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引用次数: 0

Abstract

Section snippets

How to detect indolent PC

Indolent PC can only be detected in prostate tissue that is entirely resected at radical prostatectomy (RP).

Outcomes for GG 1 PC detected in totally examined RP specimens are excellent.

Among cases for which RP specimens harbor pure GG 1 PC, metastasis to lymph nodes and distant sites and PC-specific mortality (PCSM) do not occur. Extraprostatic extension is uncommon (up to 6%) and seminal vesicle invasion is rare (0.03%).

Most incidentally detected PCs in cystoprostatectomy specimens are GG 1

Can indolent PC be reliably detected at biopsy?

A diagnosis of GG 1 PC diagnosis on needle biopsy (NBx) is not always identical to a diagnosis of GG 1 PC at RP. Reliable identification of indolent PC at NBx is not possible.

A subset of GG 1 PCs at NBx are upgraded to a higher grade at RP.

Despite the combination of magnetic resonance imaging (MRI)-targeted and systematic biopsies, substantial upgrading at RP still occurs in 22–27% of biopsy GG 1 PC cases because of sampling error or potential progression [3,4].

GG 1 PC reclassification during

How can we improve our ability to correctly classify indolent PC at NBx?

The optimal definition of indolent PC at NBx can be improved via contemporary multidisciplinary approaches.

A contemporary “histopathological definition” that captures (does not define) the majority of indolent PCs would include GG 1, no equivocal GP 3/GP 4, no cribriform PC (cribriform GP 4/intraductal carcinoma), and no stromal desmoplasia (“stromogenic” PC).

This histopathological definition must be combined with other multidisciplinary factors for optimal identification of indolent PC.

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来源期刊

European urology 医学-泌尿学与肾脏学

CiteScore

43.00

自引率

2.60%

发文量

1753

审稿时长

23 days

期刊介绍： European Urology is a peer-reviewed journal that publishes original articles and reviews on a broad spectrum of urological issues. Covering topics such as oncology, impotence, infertility, pediatrics, lithiasis and endourology, the journal also highlights recent advances in techniques, instrumentation, surgery, and pediatric urology. This comprehensive approach provides readers with an in-depth guide to international developments in urology.