Should Gleason 6 be labeled as cancer?

Ibrahim Kulac, Michael C. Haffner, Srinivasan Yegnasubramanian, Jonathan I. Epstein, Angelo M. De Marzo

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations


Pupose of review The review covers arguments for and against removing the label of 'cancer' in Gleason score 6 prostate tumors. Recent findings While there are a number of factors that determine whether men elect active surveillance, the most powerful predictor remains the Gleason score. Gleason grading remains a robust and powerful predictor of outcome in patients with prostate cancer. A pure Gleason score 6 (GS6) tumor is exceedingly unlikely to cause harm in the near term, and there have been discussions regarding whether the term cancer should still be applied. In this review, we update the largely clinico-pathological arguments that have led to the suggestion to remove the cancer label from GS6 tumors, and we provide counter arguments on the basis of practical matters of needle biopsy sampling, classical histopathology, and molecular biology findings. Summary The implications are that by retaining the label of cancer and implementing the recently proposed concept of prognostic groups, with patients harboring GS6 tumors placed into the lowest category, there is still a strong rationale in support of the choice of active surveillance or watchful waiting for most patients with GS6 lesions.

Original languageEnglish (US)
Pages (from-to)238-245
Number of pages8
JournalCurrent opinion in urology
Issue number3
StatePublished - May 27 2015


  • Gleason score
  • active surveillance
  • prostate cancer

ASJC Scopus subject areas

  • Urology


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