Focal Involvement - Help

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Veteran Member

Date Joined Mar 2009
Total Posts : 739
   Posted 3/6/2009 3:48 AM (GMT -6)   
Hi Guys, Anybody heard of "focal Involvement" when my pathology came back it read Margin status - Focally involved - location Right posterior, inferior third prostate.  Extraprostatic Extension - Nil.  It also reads it the guts of the report - In slice 2 carcinoma focally involves the right posterior surgical margin of excision within the prostatic capsule over a length of 0.5mm.  Carcinoma at the margin shows mucinous differentiation and has a gleason grade of 4 appearance, no estraprostatic extension is seen.!  Q. Does this mean a positive margin or just that it came very close to the edge of the capsule ?.  The pathology report does not mention positive margins, just focal involvement !
Age 51yrs
DX 11/11/08
6 out of 8 cores positive 3 X 60% / 3 X 10%
Gleason 3+4=7
Stage T1c
Robotic Surgery 24/12/08
Upgrade Gleason 4+3=7
Neg Margins and Nodes
Nil - Extraprostatic Extentions
Dry less than 1 week (unbelievable)
ED- taking Meds/ No result yet
PSA 28/1/09 0.03
PSA 24/2/09 0.03
"Everyday in Everyway I get better"

Veteran Member

Date Joined Feb 2008
Total Posts : 1858
   Posted 3/6/2009 5:24 PM (GMT -6)   
Sometimes it is not that clear to the layman whether the word "margin" is referring to the edge of the prostate or the edge of the surgical cut (they usually remove extra tissue around the capsule). Focal usually means a point (as in the point of a triangle). Posterior is the rear of the gland while inferior is the bottom of the gland. I believe the report is saying that there were pinpoints of cancer at the edge of the gland (in the back, lower portion) but was not through the edge of the gland. All in all it sounds like the tumour was knocking at the door. I would make sure you got a clear explanation of the pathology's meaning at your next visit with your doc............don't leave his office without knowing exactly what it means and then fill us in.
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)
PSA February 09 <0.01

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