I have a question about a post prostate removal robotic surgery pathology report. with EPE and negative margins being Gleason 8 do they usually recommend some sort of hormone or radiation therapy?
How can there be EPE but no margins involved? Does EPE neurovascular bundle mean the surgeon was not able to remove that during surgery and the cancer remains...very concerned and all help appreciated.
Pathology Report shows
Gleason 8 PSA 3/25 2.1
Extraprostatic extension: Present, focal, right superior neurovascular bundle
Seminal vesicle invasion: Not identified
Margins: Uninvolved by invasive carcinoma
Treatment effect on carcinoma: Not identified
Lymph-vascular invasion: Not identified
Pathologic staging (pTNM)
Primary tumor (pT): pT3a
Regional lymph nodes (pN): pN0
Number of lymph nodes examined: 38
Number of lymph nodes involved: 0
Size (dominant nodule, if present)
Greatest dimension: 1.8 cm
Additional dimension: 1.5 cm
bone and cat scans clear
PROSTATE AND SEMINAL VESICLES:
PROSTATIC ADENOCARCINOMA, GLEASON SCORE 8 (4+4). (SEE COMMENT)
TUMOR EXTENDING FOCALLY INTO EXTRAPROSTATIC TISSUE.
Margins of resection free of tumor.
Right and left seminal vesicles, no tumor present.
Segments of right and left vasa deferentia, no tumor present.
PERINEURAL INVASION PRESENT.
No lymphovascular invasion identified.
The prostate gland contains three foci of prostatic adenocarcinoma, two in the peripheral zone and one in the transition zone.The prostate gland contains three foci of prostatic adenocarcinoma, two in the peripheral zone and one in the transition zone. The dominant tumor focus is located in the right lateral, right posterolateral and right posterior peripheral zone. This tumor focus measures 1.8 x 1.5 cm in the largest cross-sectional dimension and it is present in the four cross sections of the prostate, extensively in the apex and focally in the base. In the right superior neurovascular bundle region, this tumor focus extends focally (2.0 mm) into extraprostatic tissue.The margins of resection are free of tumor. The second tumor focus is located in the left posterolateral peripheral zone. This tumor focus measures 0.2 x 0.1 cm in the largest cross-sectional dimension and it is present in one cross section. The third tumor focus is located in the transition zone, exclusively in the anterior apex. This tumor focus measures 0.1 x less than 0.1 cm in the largest cross-sectional dimension and it is present in a single apical section. The nondominant tumor foci are of lower histologic grade and confined in the prostate. All margins of resection are free of tumor.
Post Edited (celia01) : 4/17/2015 2:41:09 AM (GMT-6)