Findings from a recent study challenge a push to reclassify low grade prostate cancer, Biopsy Gleason Grade Group 1, as "benign."
Anthony D'Amico, MD, PhD, chief of genitourinary radiation oncology at Brigham and Women's Hospital in Boston, led researchers in analyzing data from a 31-year study out of University Hospital Hamburg-Eppendorf in Germany. The study, published July 2 in European Urology Oncology, reviewed findings from 10,228 GGG 1 prostate cancer patients who underwent a radical prostatectomy.
Of the GGG 1 patients, 9,248 were diagnosed by a transrectal ultrasound (TRUS) biopsy while 980 were diagnosed by a combination of TRUS and MRI. Adverse pathology was found in 10.33% of patients diagnosed by TRUS and in 7.86% of patients diagnosed by TRUS and MRI.
The findings indicate that 1 in 12 of the patients studied had a more aggressive form of prostate cancer than originally diagnosed, the researchers said.
Meanwhile, some physicians have called to reclassify lowest-risk prostate cancer to encourage less invasive treatment options.
While evidence demonstrates active surveillance is an effective way to manage low-grade prostate cancer, around 40% of men with a lower-grade diagnosis choose more aggressive treatment options, Becker's reported earlier this year. Physicians have proposed referring to it as a premalignant lesion instead.
The study identified two risk factors for physicians to use to inform treatment plans: Patients with a high prostate-specific antigen level or patients whose cancer is found in 50% or more of their biopsy samples have a higher risk of disease and death.
"For patients with GGG1 who are at heightened risk, we should continue to call their diagnosis cancer," Dr. D'Amico said in a July 9 news release from Somerville-Mass.-based Mass General Brigham.