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Extraprostatic Extention - T2 or T3 ?

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Posted 9/22/2009 6:38 AM (GMT 0)
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.

Posted 9/22/2009 12:38 PM (GMT 0)
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.
Posted 9/22/2009 10:13 PM (GMT 0)
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.
Posted 9/22/2009 10:26 PM (GMT 0)
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
Posted 9/22/2009 11:47 PM (GMT 0)
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.
Posted 9/23/2009 12:08 AM (GMT 0)
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.
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