path interpretation

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Regular Member

Date Joined Dec 2008
Total Posts : 60
   Posted 12/27/2008 7:18 AM (GMT -6)   
I was reviewing my post surgical path.  All of the news was good but there was a line for apical involvement and it was positive.  I have tried to surf for an answer but I am not sure if I understand.  Maybe someone here can add to what I have read.
The line on the report must be important so I want to understand.  The best I can understand is that if the cancer is in the apex than the membrane around that area is thinner and the chances of cancer passing through is greater. 
Age at Dx:48, currently 49
PSA May 08 2.96
referred to uro
PSA June 08 3.44
biopsy 7/25/08-29 core samples
path 7/31/08-8 of 29 PCa/10% involved L/R base and mid
high grade PIN in apex/seminal vesicles clear stage GS 3/3=6 pT2a
10/7/08 robotic at Cleveland Clinic-Dr. Kaouk
10/10/08 path GS 3/3=6 pT2c
cancer contained/neg margins

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4462
   Posted 12/27/2008 8:45 AM (GMT -6)   

Your interpretation seems to match what I could find about it.  Quote from a study about that exact thing:

"A positive surgical margin at the prostatic apex in the absence of positive margins or extraprostatic extension elsewhere does not confer a worse prognosis than organ confined disease. In this study the recurrence rate for patients with positive apical margins was the same as for those with confined disease."

I read that to say, if there's no expansion to margins or other tissue elsewhere, then the risk of it coming back is the same as from organ contained PCa, which is as good a risk factor as we can expect from surgery.

James C.         Age 61
Co-Moderator- Prostate Cancer Forum
4/19/07 PSA 7.6, referred to Urologist, recheck 6.7
7/11/07 Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07 Path report: 3 of 16 PCa, 5% involved, left lobe , GS 3/3:6.
9/24/07 (open) Retropubic Radical Prostatectomy performed
9/26/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
16 mts: ED- Viagra, pump continues, no response- Trimix ..35ml x 2 weekly continues
Post Surgery PSA's: 3 mts-.04, 6 mts.-.04, 9 mts.-.04, 1 Year-.02.

Veteran Member

Date Joined Apr 2006
Total Posts : 1732
   Posted 12/27/2008 10:38 AM (GMT -6)   
The apex is narrow, thinner and hasn't a defined edge. The nerve sheath also comes in tightly at the apex, making that area a more likely place for them bugger cells to head. It's mentioned because of a pedisposition for spread in otherwords.

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