Genitourinary Pathology Society and International Society of Urological Pathology white paper on defining indolent prostate cancer Journal Article


Authors: Shah, R. B.; Paner, G. P.; Cheng, L.; De Marzo, A. M.; Magi-Galluzzi, C.; Varma, M.; Zhou, M.; Amin, A.; Amin, M. B.; Aron, M.; Cunha, I. W.; Epstein, J. I.; Fine, S. W.; Haider, A.; Iczkowski, K. A.; Kench, J. G.; Kunju, L. P.; Mohanty, S. K.; Montironi, R.; Netto, G. J.; Pan, C. C.; Rao, P.; Srigley, J. R.; Sauter, G.; Tan, P. H.; Tsuzuki, T.; van der Kwast, T. H.; van Leenders, G. J.; Kristiansen, G.
Article Title: Genitourinary Pathology Society and International Society of Urological Pathology white paper on defining indolent prostate cancer
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. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: prostate cancer; active surveillance; carcinoma; indolent; grade group 1
Journal Title: American Journal of Surgical Pathology
ISSN: 0147-5185
Publisher: Lippincott Williams & Wilkins  
Publication status: Online ahead of print
Date Published: 2025-05-30
Online Publication Date: 2025-05-30
Language: English
DOI: 10.1097/pas.0000000000002425
PROVIDER: scopus
PUBMED: 40444986
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Samson W Fine
    466 Fine