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Posted 1/31/2015 7:25 PM (GMT 0)
A few questions about final pathology report

First, is there a difference between extra prostatic extension and extra capsular extension? Or are they used interchangeably? More specifically, I'm wondering if EPE means it did not escape the Prostate, nor did it invade the capsule , while ECE might mean it may have escaped the Prostate, but not the capsule. I'm guessing they are used interchangeably, but it's a question that occurred to me.

Second, on my oath report, it says 2 of the margin specimens were positive on frozen section, but negative on final pathology. But then in the synopsis section, it lists the following:

A. True Margin negative for carcinoma
B. TrueMargin negative for carcinoma
C. True margin negative for carcinoma
D. Negative for tumor.

Doesn't this imply that there were THREE positive marginson. Frozen section? The report only specifies two Frozen section positive and final negative margins

But then in another section of the synoptic format report it says:
Final margins uninvolved by carcinoma

Anybody understand this? It looks like there were 3 positive margins on Frozen section , and two final marhins negative, but then it says final margins negative.

Post Edited (Pratoman) : 1/31/2015 12:31:18 PM (GMT-7)

Posted 1/31/2015 7:31 PM (GMT 0)
Prato, ECE and EPE are interchangeable, unless my surgeon doesn't know what he's talking about. Regarding the margins, the frozen sections taken during surgery were positive that's why he cut wider to get negative margins in that area. Final path negative margins is my read.

Cheers, Doug
Posted 1/31/2015 7:36 PM (GMT 0)
Doug, but what confuses me is that there are 2 samples listed with positive margins and final negative margins, but then the A,B,C!D listing seems to imply that there were 3 "final" margins, which would mean 3 positive on Frozen section.

Maybe I'm reading too much into it. What else is new
Posted 1/31/2015 7:51 PM (GMT 0)
I do think you're reading too much into it but I sure could be wrong.

The frozen samples were taken during surgery while you were open right? They were sent to the pathologist, he read them and reported back positive so your surgeon cut wider to get negative margins which was reported on final path report, right. I read your FINAL margins as negative.

As for A,B,C,D, I would hazard to guess they are samples labeled from 4 locations rather than concentric rings.

Bottom line negative margins. Again my read. Others may have a different interpretation.

Cheers, Doug
Posted 1/31/2015 7:56 PM (GMT 0)
Cancer outside the prostate is called ECE before surgery (for example, if seen on an MRI) and EPE after surgery (based on actual pathology). I don't know why the same exact finding has two different names.
Posted 1/31/2015 8:56 PM (GMT 0)
I agree with Bluebird - ECE is a clinical finding, EPE is a pathology finding.

Didn't you ask this already about your negative margins? The answer is still the same: negative is negative, contained is contained. It doesn't matter that your surgeon had to take some slices to get to a negative margin (unless you worry about slicing into the cancer - but don't). The answer remains the same no matter how much you obsess over it. There's nothing to see here -- move along.

- Allen
Posted 1/31/2015 9:04 PM (GMT 0)
No Casper! Now don't you dare say anything shakehead
Posted 1/31/2015 9:34 PM (GMT 0)
No Allen, you are misunderstanding my question. I know that there is no implication that he had to cut more to get the negative final margin.

What my question is, and its not a giant concern, I am just curious is that it says there were 2 final margins that were negative. But in another section it lists 4 margins, one negative for tumor, the other three negative "FINAL" margins. This would imply to me, that there were THREE margins that had to be cut wide, not two.

I'm not concerned, because the synoptic format section of the report, says margins: negative. But I am curious.

I've created a monster here, where whenever I ask a question, people think I am obsessing. I am not obsessing , just curious why its listed that way.

Thanks for the responses on the ECE/EPE
Posted 1/31/2015 9:37 PM (GMT 0)
Remember the old parable about the boy who cried Wolf, Prato? No offence Buddy!

Cheers, Doug
Posted 1/31/2015 9:41 PM (GMT 0)
Sorry I misunderstood. Perhaps call the pathologist to request clarification.
Posted 1/31/2015 9:42 PM (GMT 0)
Look at my latest thread Prato. Now there's something to worry about! LOL, it happens to be true though.

Cheers, Doug
Posted 2/1/2015 2:12 AM (GMT 0)
Epe means it escaped the prostate. ECE means it also escaped the capsule.If you had a negative margin it means it escaped the specimen The prostate is... well its the prostate. The capsule is the added protection around the prostate. As Walsh said in is book, the prostate is gift package{presumedly the gift is seminal fluid} tthe capsule is the gift packages wrapping paper. To continue to the point before the last sentence. The specimen is the whole blob of blob that the surgeon presents {gift} to the pathologist. Prato you seem to have stopped doing your homework and relying on the forum to do it for you. You are not a newbie anymore, by definition. Whose definition, well…. I reckon …mine! pay close attention to my caveat below on this one.
I also believe these terms are not clinical terms but pathological. But I've had folks run clinics on me before, NJS would know, he ran the last clinic on me and is quite knowledgable with little regard, but I think he likes it that way, and I respect that…highly. And of course there is my guru AZ4peaks….
Posted 2/1/2015 2:17 AM (GMT 0)
Logos, you said....

".If you had a negative margin it means it escaped the specimen The prostate is... well its the prostate. "

Also you seem to be sating year ECE and EPE are two different things , which is different than others interpretation here.

I assume you meant if you had a POSITIVE margin. Although I'm not sure that's correct either?

No, I didn't stop doing my o homework, actually I did google to find the answer, but couldn't find anything. I found some things that seemed to imply that the two terms were the same, but nothing definitive.
Posted 2/1/2015 2:20 AM (GMT 0)
Prato Correctomundo, thank you Prato. I feel my work is done, go in peace… or something like that and yes I believe they are 2 different acronyms that possibly have become synonyms in some eye's do to degradation of thought which is seeping thru the worlds multicultural…er, ah….whatamacallit faster than a wet mypad!!! :school: school me, pleaze, somebahdy school me scool
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