Elsevier

EBioMedicine

Volume 26, December 2017, Pages 17-24
EBioMedicine

Review
Proposed Terminology and Classification of Pre-Malignant Neoplastic Conditions: A Consensus Proposal

https://doi.org/10.1016/j.ebiom.2017.11.024Get rights and content
Under a Creative Commons license
open access

Highlights

  • Premalignant neoplastic conditions are characterized by early somatic events without evidence of an overt neoplasm.

  • Overt neoplasms can be divided into premalignant (indolent) neoplasms and malignant (aggressive) neoplasms.

  • An updated nomenclature and classification of clonal conditions seems of utmost importance in the genome era of medicine.

Abstract

Cancer evolution is a step-wise non-linear process that may start early in life or later in adulthood, and includes pre-malignant (indolent) and malignant phases. Early somatic changes may not be detectable or are found by chance in apparently healthy individuals. The same lesions may be detected in pre-malignant clonal conditions. In some patients, these lesions may never become relevant clinically whereas in others, they act together with additional pro-oncogenic hits and thereby contribute to the formation of an overt malignancy. Although some pre-malignant stages of a malignancy have been characterized, no global system to define and to classify these conditions is available. To discuss open issues related to pre-malignant phases of neoplastic disorders, a working conference was organized in Vienna in August 2015. The outcomes of this conference are summarized herein and include a basic proposal for a nomenclature and classification of pre-malignant conditions. This proposal should assist in the communication among patients, physicians and scientists, which is critical as genome-sequencing will soon be offered widely for early cancer-detection.

Keywords

Pre-malignant states
Neoplastic stem cells
Clonal evolution
Cancer

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We dedicate this article to the visionary concepts established by Paul Ehrlich and Theodor Boveri