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

• Published in: EBioMedicine 2017-12, Vol.26 (C), p.17-24
• Main Authors: Valent, Peter, Akin, Cem, Arock, Michel, Bock, Christoph, George, Tracy I., Galli, Stephen J., Gotlib, Jason, Haferlach, Torsten, Hoermann, Gregor, Hermine, Olivier, Jäger, Ulrich, Kenner, Lukas, Kreipe, Hans, Majeti, Ravindra, Metcalfe, Dean D., Orfao, Alberto, Reiter, Andreas, Sperr, Wolfgang R., Staber, Philipp B., Sotlar, Karl, Schiffer, Charles, Superti-Furga, Giulio, Horny, Hans-Peter
• Format: Article
• Language: English
• Subjects: Cancer; Clonal evolution; Neoplastic stem cells; Pre-malignant states; Review
• ISSN: 2352-3964; 2352-3964
• DOI: 10.1016/j.ebiom.2017.11.024

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. •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.