Letters to the Editor

Should pathologists and clinicians continue to consider Grade Group 1 (Gleason score ≤6) prostate cancer as a true carcinoma? Let’s hear from patient advocates

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Received: 24 April 2025
Published: 10 June 2025
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To the Editor,

The current grading system for prostate cancer (PCA) includes 5 Grade Groups (GG): GG1 (Gleason score ≤ 6); GG2 (Gleason score 3+4); GG3 (Gleason score 4+3); GG4 (Gleason score 4+4; or 3+5; or 5+3); GG5 (Gleason scores 4+5/5+4/5+5). The GG system is one of the most important predictors of outcome in PCA patients...

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Montironi R, Cheng L, Cimadamore A, et al. Narrative review of prostate cancer grading systems: will the Gleason scores be replaced by the Grade Groups? Transl Androl Urol. 2021; 10:1530-1540. DOI: https://doi.org/10.21037/tau-20-853

Mazzucchelli R, Barbisan F, Scarpelli M, et al. Is incidentally detected prostate cancer in patients undergoing radical cystoprostatectomy clinically significant? Am J Clin Pathol. 2009; 131:279-283. DOI: https://doi.org/10.1309/AJCP4OCYZBAN9TJU

Shah RB, Paner GP, Cheng L, et al. Genitourinary Pathology Society and International Society of Urological Pathology white paper on defining indolent prostate cancer: call for a multidisciplinary approach. Eur Urol. 2025:S0302-2838(25)00150-2. Online ahead of print.

Epstein JI, Kibel AS. Renaming Gleason score 6 prostate to noncancer: a flawed idea scientifically and for patient care. J Clin Oncol. 2022;40:3106-3109. DOI: https://doi.org/10.1200/JCO.22.00926

Ross HM, Kryvenko ON, Cowan JE, et al. Do adenocarcinomas of the prostate with Gleason score (GS) =6 have the potential to metastasize to lymph nodes? Am J Surg Pathol. 2012; 36:1346-1352. DOI: https://doi.org/10.1097/PAS.0b013e3182556dcd

Anderson BB, Oberlin DT, Razmaria AA, et al. Extraprostatic extension is extremely rare for contemporary gleason score 6 prostate cancer. Eur Urol. 2017; 72:455-460. DOI: https://doi.org/10.1016/j.eururo.2016.11.028

Lokman U, Erickson AM, Vasarainen H, et al. PTEN loss but not ERG expression in diagnostic biopsies is associated with increased risk of progression and adverse surgical findings in men with prostate cancer on active surveillance. Eur Urol Focus. 2018; 4:867-873. DOI: https://doi.org/10.1016/j.euf.2017.03.004

Carter HB, Helfand B, Mamawala M, et al. Germline mutations in ATM and BRCA1/2 are associated with grade reclassification in men on active surveillance for prostate cancer. Eur Urol. 2019; 75:743-749. DOI: https://doi.org/10.1016/j.eururo.2018.09.021

Zhou M, Amin A, Fine SW, et al. Should grade group 1 prostate cancer be reclassified as "non-cancer"? A pathology community perspective. Urol Oncol. 2023; 41:62-64. DOI: https://doi.org/10.1016/j.urolonc.2022.09.028

Saoud R, Woranisarakul V, Paner GP, et al. Physician perception of grade group 1 prostate cancer. Eur Urol Focus. 2023;9:966-973. DOI: https://doi.org/10.1016/j.euf.2023.04.002

How to Cite



Should pathologists and clinicians continue to consider Grade Group 1 (Gleason score ≤6) prostate cancer as a true carcinoma? Let’s hear from patient advocates. (2025). Archivio Italiano Di Urologia E Andrologia, 97(2). https://doi.org/10.4081/aiua.2025.13925