Extraprostatic Extention - T2 or T3 ?

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Radical
Veteran Member


Date Joined Mar 2009
Total Posts : 739
   Posted 9/22/2009 12:38 AM (GMT -6)   
Hi Guys,
 
I am a little confused, and hoping someone can clear the muddy waters.  Extraprostatic Extention would also indicate Stage T3. ie they both relate to the tumor being extended outside of the capsule.  That I understand, but how is it I read some posts whom have Stage 2, and also have Extraprostatic Extentions, would this not now become Stage 3 , or is it possible to have Final path, Stage 2 with EPE ?
I have also seen in some signatures the situation the other way around, where they have  Nil- EPE, but are a Stage 3, is this possible ?..........................Cheers Kev.
Age 51yrs
DX 11/11/08
6 out of 8 cores positive 3 X 60% / 3 X 10%
PSA 4
Gleason Score 3+4=7
Stage T1c
Robotic Surgery 24/12/08
Upgrade Gleanson Score 4+3=7 Gleason Differential 60%/40%
Stage T2c
Three small foci total volume <10%
Neg Margins and Nodes
Nil - Extraprostatic Extentions
Dry less than 1 week.
ED- taking Meds- Its been 9 mnths now getting some action ! yah
PSA 1/09  .03
PSA 2/09  .03
PSA 5/09  .03
PSA 9/09  .03
"Everyday in Everyway I get better"


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 9/22/2009 6:38 AM (GMT -6)   
NotHard, my husband was restaged to t3a post surgery due to a single, minute EPE. I asked the urologist/surgeon the same question because I've read differing definitions and he said husband is t3a due to the extension. Fortunately all margins were clear as surgeon assumed he'd find EPE because one of the two positive biopsy samples was very close to the edge of the prostate.

Stage 3 indicates the cancer is outside the prostate gland proper. There seem to be differing medical opinions about exactly what constitutes the prostate capsule. 3a includes EPE and 3b includes seminal vesicles and/or bladder involvement (I think).

I ask the surgeon whether my husband's PCa was considered local or regional after the surgery...his answer, inbetween the two. Oh well, it is what it is.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a due to minuscule extraprostectic extension in posterior left. Margins, bladder neck and SV clean. Gleason 3+4 (no change from biopsy). PSA of 0.0 every 3 months since surgery. In August 2009, PSA reading of 0.1 - urologist will retest in 4 weeks. Hoping this is a blip. Incontinence good to excellent but still having issues with leakage. ED is a work in progress (with the help of Viagra).


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 9/22/2009 4:13 PM (GMT -6)   
I don't know the answer to your question, but my path did show EPE and my uro says that it does not show that the cancer has spread, but it is an extra cause for concern.
On the other hand, most EPEs are measured in milimeters, which is to say, microscopic, so I remain hopeful that they got it all.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads


Radical
Veteran Member


Date Joined Mar 2009
Total Posts : 739
   Posted 9/22/2009 4:26 PM (GMT -6)   
Thanks Geezer, So are you staged T3 or T2(final path), I would assume you would be Stage T3, if you have EPE.  Certainly very confusing to me...............Rgds Kev
Age 51yrs
DX 11/11/08
6 out of 8 cores positive 3 X 60% / 3 X 10%
PSA 4
Gleason Score 3+4=7
Stage T1c
Robotic Surgery 24/12/08
Upgrade Gleanson Score 4+3=7 Gleason Differential 60%/40%
Stage T2c
Three small foci total volume <10%
Neg Margins and Nodes
Nil - Extraprostatic Extentions
Dry less than 1 week.
ED- taking Meds- Its been 9 mnths now getting some action ! yah
PSA 1/09  .03
PSA 2/09  .03
PSA 5/09  .03
PSA 9/09  .03
"Everyday in Everyway I get better"


reachout
Veteran Member


Date Joined May 2009
Total Posts : 725
   Posted 9/22/2009 5:47 PM (GMT -6)   
I was staged pT2c after my surgery and the pathology report showed negative extraprostatic extension, negative margins, but microscopic extracapsular extension noted. Go figure that one. I asked my urologist if I should be a T3 and he said the prognosis is the same, that I should have a good chance of a cure. My suspicion is that with microscopic extension they can go either way, T2 or T3. There are different levels of T3, and I see from some papers that there is some discussion about formalizing that and making grades for very small T3 extensions versus more significant ones.
Age 64 yrs
DX 5/2009
8 out of 12 cores positive
PSA 5.6
Gleason Score 3+4=7
Stage T2a
Da Vinci Surgery 08/07/2009
Upgrade Gleanson Score 4+3=7
Stage pT2c
Neg Margins and Nodes
Neg Extraprostatic Extention
Dry immediately
Waiting for first PSA


cave88
Regular Member


Date Joined Jul 2008
Total Posts : 76
   Posted 9/22/2009 6:08 PM (GMT -6)   
Kev,
I believe the staging can also have to do with how the cancer cells appear relative to the regular non-cancerous prostate cells. Cell differentiation.
age:  46
1st psa Apr 08 3.06
2nd psa 6/16/8 4.02,  DRE showed nothing abnormal
biopsy 7/10/08 positive 5 of 12
Da Vinci 8/04/8 Parkview Memorial in FT Wayne IN 
gleason 3 + 3 = 6
prostate 27 g, 4 x 4 x 3.1 cm
Stage:  pT2cNXMX
margins:  apical margin involved
no extraprostatic extension of tumor
seminal vesicle involvement: absent
3 month psa  0.11, 11/08
6 month psa 0.12,  2/09/0
9 month psa 0.13, 5/01/09
1 year psa 0.20, 8/17/2009
 
 
 

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