Pathology Report after Robotic Prostate Surgery

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Sharp18
Regular Member


Date Joined Mar 2010
Total Posts : 78
   Posted 3/12/2010 9:25 PM (GMT -6)   
Does anyone understand the following statements from Pathology report done after Robotic Prostate Surgery?
 

"High-grade prostatic intraepithelial neoplasia (HGPIN): Present focally" and

 

"Perineural infiltration: Present"

 

"Stage pT2cNX"

 

All remaining data is good (negative)


goodlife
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Date Joined May 2009
Total Posts : 2692
   Posted 3/12/2010 9:39 PM (GMT -6)   
High grade pins are the pre-cursor to to cancer cells. It makes it sound like you really caught it early.

The perinueral infiltration says that the cancer cells were found in the nerves in the prostate capsule. This could be a potentail pathway to the outside, but many doctors kind of ignore it.

It would really help us if you could post the entire report in your signature. The pT2cNX implies that also found adenocarcinoma.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01


Sharp18
Regular Member


Date Joined Mar 2010
Total Posts : 78
   Posted 3/12/2010 10:25 PM (GMT -6)   

Here are Synoptic Comments for Prostate Tumors:

 

Any comments will be appreciated

 

Type of tumor:  Small acinar adenocarcinoma. 

location of tumor: Left posterior midland, slide A12, A13; left anterior midland, slide A16, A17; right posterior midgland, slide A8.

Estimated volume of tumor: 0.34 cc.   

Gleason score: 4+3; primary pattern 4, secondary pattern 3.

Estimated volume > Gleason pattern 3:  90%.

Involvement of capsule: None.

Extraprostatic extension: None.

Margin status for tumor: Negative.

Margin status for benign prostate glands: Cauterized glands at present at inked margin (right apex, slide A1) and likely represent benign prostate but are too distorted by cautery to fully characterize. 

High-grade prostatic intraepithelial neoplasia (HGPIN): Present; focally.

Tumor involvement of seminal vesicle:  None.  – Peroneural infiltration:  Present.  Lymph node status:  None present. 

AJCC/U1CC stage:  pT2cNX


goodlife
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Date Joined May 2009
Total Posts : 2692
   Posted 3/12/2010 10:38 PM (GMT -6)   
This looks like a pretty good report, but there are some confusing statements that you may need the doctor to explain.

It sounds as though they cauterized the margin of the prostate, and are not sure if it was a negative margin at that point or not.

The focal presence of HPINS would appear to say that there were some precancerous cells in the margin.

This is just my non-expert opinion. Sounds like a session with the doctor is in order.

Good Luck and welcome to Healing Well. I am sure some more knowledgable guys than me will chime in.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01


Sharp18
Regular Member


Date Joined Mar 2010
Total Posts : 78
   Posted 3/12/2010 10:44 PM (GMT -6)   
Thanks!

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 3/13/2010 7:29 AM (GMT -6)   
Sharp, sounds like you're good to go. Congratulations.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009- 0.1, September 0.3, October back to 0.0, December 0.0. Thank you God!


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 3/13/2010 9:50 AM (GMT -6)   
Sharp18, welcome to the forum and thanks for coming....
James C. Age 62
Co-Moderator- Prostate Cancer Forum
Gonna Make Myself A Better Man: www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
32 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


tarhoosier
Regular Member


Date Joined Mar 2010
Total Posts : 495
   Posted 3/13/2010 10:53 AM (GMT -6)   
You had robotic surgery as the cauterization is an element of that machine and technique. My question about the cautery margin: Does this indicate that some prostate gland tissue remains in your body?

Sharp18
Regular Member


Date Joined Mar 2010
Total Posts : 78
   Posted 3/13/2010 10:57 AM (GMT -6)   
I hope that the answer in "no", but I am not sure...
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