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Post Prostatectomy Two Week Progress
Prostate Cancer | Last Active: Feb 27 3:30pm | Replies (36)Comment receiving replies
Jeff,
Yes:
Grade group 2 (Gleason Score 3 + 4 = 7) Percentage of Pattern 4: 11 - 20% Intraductal Carcinoma (IDC): Not identified
Cribriform Glands: Present
Estimated Percentage of Prostate Involved by Tumor: 21 - 30%
Extraprostatic Extension (EPE): Not identified
Urinary Bladder Neck Invasion: Not identified
Seminal Vesicle Invasion: Not identified
Lymphatic and / or Vascular Invasion: Not Identified
Perineural Invasion: Present
Invasive carcinoma present at margin
Linear Length of Margin(s) Involved by Carcinoma: Greater than or equal to 3 mm (non-limited)
Margin(s) Involved by Invasive Carcinoma: Left posterior
REGIONAL LYMPH NODES Regional Lymph Node Status: : All regional lymph nodes negative for tumor
Number of Lymph Nodes Examined: 3
pTNM CLASSIFICATION pT2 pN Category: pN0
On the positive margin; that worried me at first, but my surgeon said that when he was pulling the prostate out, and trying to spare my nerves, the region where the margin is stuck to the prostate capsule and tore. To pathologists using their ink, it would appear as a positive margin. My surgeon feels confident that he didn't leave any cancer behind. So hopefully that is just, you know, a little hiccup in the process and not a true cancer margin.
Thanks for all your helpful and knowledgeable posts on this forum.
Quaddick
Replies to "Jeff, Yes: Grade group 2 (Gleason Score 3 + 4 = 7) Percentage of Pattern 4:..."
@quaddick Very very happy for you, Quaddick! Since finding out that you chose to go the "RALP, using a da Vinci machine" route, I've been researching prostatectomy in 75+ men. Not much out there... Excited to find a paper --scanned to the top and it was published in 20171
It was rewarding finding someone else who scored HIGH RISK on both Prostox Ultra (SBRT) and Prostox (CFRT). But the best part of this all, is you're happy with your decision. *And* I'm grateful that you've shown the way for my husband and me.
Live Long and Prosper ..V.
Warmest regards from Canada
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@quaddick
Just to make you feel more confident ask the doctor to confirm that Cribriform Glands: Present Is related to small cribriform not large cribriform.
Good to see you’re still a 3+4 that’s a real positive thing. So many get upgraded.
It does mention PNI but that is really not something people normally have to worry about. It was interesting that in a recent video about active surveillance that doctor said they ignore that.
Now the issue the doctor say is nothing. i’m not saying it is significant, but this is from the NIH
In prostate cancer pathology, a non-limited surgical margin (linear length ≥ 3 mm) is clinically significant because it is a key predictor of biochemical recurrence (BCR)—the rising of PSA levels after surgery
Higher Recurrence Risk: A linear length of ≥ 3 mm is associated with a significantly higher risk of recurrence compared to "limited" margins (< 3 mm). One meta-analysis found that patients with margins ≥ 3 mm had a nearly twofold higher risk of BCR than those with smaller positive margins.
The fact that you are a 3+4 really does reduce the incidents of BCR, but you need to be aware that it’s possible. This is probably something you want to talk to the doctor about. Why did it come up ≥ 3 mm which is significant rather than < 3mm Which is not significance.