MY NEW PATH REPORT FROM DR. EPSTEIN

MGUNS

Ladies and Gents just received the Dr. Epstein Pathology report:

The New as of 9/30/2019

HISTOLOGIC TYPE: Adenocarcinoma (conventional, NOS)

GLEASON SCORE DOMINANT NODULE: 3+4=7

Grade Group: 2: 30% Pattern 4

GLEASON SCORE SECONDARY NODULE: 3+3=6

Grade Group: 1

TUMOR EXTENT: Moderate

location, Dominant Nodule: left, posterolateral. apex, mid base

location Secondary Nodule: Right Anterior

Margins: POSITIVE , location and nature of positive margins: Left Posterolateral, focal. Positive in an area of intraprostatic incision (II) Summed length of positive margin: 3mm Highest grade at margin 3+4=7

Seminal Vesicle Invasion: None

Lymphatic (Small Vessel) Invasion: Absent

Extent of invasion (8th edition AJCC):

Primary Tumor pT2x: Organ confined elsewhere , unevaluable in area of positive margin

Regional Lymph Nodes: pNx: Cannot be assessed

Summary Margins: Positive
Grade groups range from 1 (Most Favorable) to 5 (Least Favorable)

VascodaGama

Intraprostatic margins

Guns,

All the results are good in this report except for the finding of Gleason grade 4 at the positive margin. The pathological stage of pT2x (pT2+) means that there is a possibility for EPE (extraprostatic extensions) which would set the stage at pT3a, however, on Epstein's opinion (and this is to be trusted for his long experience) the risk for recurrence exist but it is is low (grade 2 in 1 to 5). In fact, all surgeries have positive margins at the two incisions done to separate the gland at the bladder neck and at the colon outer lining. The outer skin (shell) retreats back (like cutting a rubber pipe) and that is reported as positive intraprostatic margins.
Tiumor at two sites with different Gs refers to cancer that forms a mass of accumulated cells not as spread micrometastatic colonies. Negative lymph nodes and negative vesicles (SV) sugest that cancer was contained (pT2).
I also had a 3mm positive intraprostatic margin but had a larger portion of the gland (2/3) infested with micrometastatic type of cancer which graded me with pT3a. That was correct and soon I experienced recurrence. My Gleason grade was all 3 so that I am still alive 19 years post op.

I wonder about the comment of your doctor on the report. In my lay opinion you need only to care for the side effects and enjoy life.

Best wishes

VG

MGUNS

VascodaGama,

VascodaGama,

Thank you for your insight, very good information. I have my first PSA on 11/12/19