Genitourinary Pathology Society and International Society of Urological Pathology White Paper on Defining Indolent Prostate Cancer

A significant subset of well-differentiated prostatic acinar neoplasms with invasive histologic features will not spread outside of the prostate, become symptomatic, or shorten a patient's life even if the tumor is left untreated. Overdiagnosis and overtreatment of these indolent prostate cancers (PCa) remain a significant health care problem despite the improved risk assessment and uptake in acceptance of conservative management. While detection of indolent PCa on an entirely resected prostate is possible, recognition of indolent PCa on a needle biopsy (NBX) cannot be reliably made as Grade Group 1 (GG1) PCa diagnosis on NBX is not always identical to one from radical prostatectomy due to a variety of reasons. Further, some of the initially diagnosed GG1 PCas on NBX and carefully monitored on active surveillance (AS) are later reclassified with higher grades. At the same time, other GG1 PCas never progressed on long-term follow-up while receiving no therapy. The overarching goal of this white paper by the 2 leading uropathology organizations, Genitourinary Pathology Society (GUPS) and International Society of Urological Pathology (ISUP), is to help identify a path toward a more meaningful multidisciplinary solution addressing the pervasive problem of overdiagnosis of indolent PCa and its downstream negative effects. Herein, GUPS and ISUP jointly release statements that address why recognition of indolent PCa cannot be reliably made in NBX and why various contemporary multidisciplinary approaches are needed to help improve the detection of indolent PCa in NBX.

Authors

Institutions

Publication Details

Journal
The American Journal of Surgical Pathology
Published
2025-05-30
DOI
https://doi.org/10.1097/pas.0000000000002425
Citations
4
Primary Topic
Prostate Cancer Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
6.07
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Genitourinary Pathology Society and International Society of Urological Pathology White Paper on Defining Indolent Prostate Cancer

Glen Kristiansen, Kenneth A. Iczkowski, Samson W. Fine, Guido Sauter et al.
4 citations
The American Journal of Surgical Pathology
Prostate Cancer Diagnosis and Treatment
6.07
article

Genitourinary Pathology Society and International Society of Urological Pathology White Paper on Defining Indolent Prostate Cancer

Glen Kristiansen, Kenneth A. Iczkowski, Samson W. Fine, Guido Sauter, Sambit K. Mohanty, Toyonori Tsuzuki, Cristina Magi‐Galluzzi, Gladell P. Paner, Manju Aron, Rodolfo Montironi, Priya Rao, Theodorus van der Kwast, Ali Amin, Rajal B. Shah, George J. Netto, Puay Hoon Tan, Murali Varma, Angelo M. De Marzo, James G. Kench, Liang Cheng, Ming Zhou, Mahul B. Amin, Geert J. van Leenders, John R. Srigley, Aiman Haider, Chin-Chen Pan, Lakshmi P. Kunju, Isabela W. Cunha, Jonathan I. Epstein
article en
4 citations

Abstract

A significant subset of well-differentiated prostatic acinar neoplasms with invasive histologic features will not spread outside of the prostate, become symptomatic, or shorten a patient's life even if the tumor is left untreated. Overdiagnosis and overtreatment of these indolent prostate cancers (PCa) remain a significant health care problem despite the improved risk assessment and uptake in acceptance of conservative management. While detection of indolent PCa on an entirely resected prostate is possible, recognition of indolent PCa on a needle biopsy (NBX) cannot be reliably made as Grade Group 1 (GG1) PCa diagnosis on NBX is not always identical to one from radical prostatectomy due to a variety of reasons. Further, some of the initially diagnosed GG1 PCas on NBX and carefully monitored on active surveillance (AS) are later reclassified with higher grades. At the same time, other GG1 PCas never progressed on long-term follow-up while receiving no therapy. The overarching goal of this white paper by the 2 leading uropathology organizations, Genitourinary Pathology Society (GUPS) and International Society of Urological Pathology (ISUP), is to help identify a path toward a more meaningful multidisciplinary solution addressing the pervasive problem of overdiagnosis of indolent PCa and its downstream negative effects. Herein, GUPS and ISUP jointly release statements that address why recognition of indolent PCa cannot be reliably made in NBX and why various contemporary multidisciplinary approaches are needed to help improve the detection of indolent PCa in NBX.

The American Journal of Surgical PathologyVol. 49(12)
Marche Polytechnic University (IT), University College Hospital (GB), University Health Network (CA), Memorial Sloan Kettering Cancer Center (US), The University of Texas MD Anderson Cancer Center (US), Johns Hopkins University (US), Universität Hamburg (DE), Aichi Medical University (JP), University of Toronto (CA), Brown University (US), University of Michigan (US), University Hospital Bonn (DE), Royal Prince Alfred Hospital (AU), Government of Haryana (IN), Keck Hospital of USC (US), University Hospital of Wales (GB), Taipei Veterans General Hospital (TW), University of Alabama at Birmingham (US), University of Chicago (US), Integra (United States) (US), D’Or Institute for Research and Education (BR), University Medical Center Hamburg-Eppendorf (DE), Erasmus MC Cancer Institute (NL), Hospital São Paulo (BR), University College London (GB), University of Tennessee at Knoxville (US), University of Pennsylvania (US), University of California, Davis (US), The University of Texas Southwestern Medical Center (US), Icahn School of Medicine at Mount Sinai (US)
Good health and well-being
Openalex Percentile: Top 4%
Prostate Cancer Diagnosis and Treatment
6.07
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.