Recent research underscores the complexities of diagnosing prostate cancer, particularly regarding Gleason Grade Group (GGG) 1, the lowest classification of prostate cancer. While some experts have suggested reclassifying GGG1 as ‘benign,’ a new study led by researchers from Mass General Brigham reveals that a significant number of patients with this diagnosis may actually harbor more aggressive forms of the disease. Analyzing data from over 10,000 patients treated at a German university hospital, the study found that at least 8% of GGG1 patients exhibited aggressive cancer characteristics. Crucially, high PSA levels and more than 50% positivity in biopsy samples were identified as key indicators of heightened risk. The findings, published in European Urology Oncology, advocate for maintaining the cancer classification for these higher-risk patients, suggesting that it could lead to improved treatment strategies and reduced mortality risk.
Dr. Anthony D’Amico, senior author of the study, emphasized the importance of accurately labeling GGG1 patients who exhibit these risk factors as having cancer, allowing for timely intervention. The study examined data from 10,228 patients who underwent radical prostatectomy, revealing that 10.33% of those diagnosed via transrectal ultrasound-guided biopsies and 7.86% diagnosed through a combined TRUS and MRI approach showed adverse pathology at surgery. Although the study had limitations, such as being confined to a single institution, its results highlight the potential consequences of misclassifying GGG1 prostate cancer. D’Amico advocates for more proactive clinical measures, such as follow-up biopsies or genomic testing, for patients with high-risk indicators, facilitating informed discussions about treatment options and ultimately improving patient outcomes.
