Post RALP Pathology Report In: Experts?

I've seen my Path report on MyChart. No conversation with Dr. Han as yet. Overall it looks good to my amateur eyes. The only negative being EPE but margins are negative. No nodes. No SV. Here is some of the report below.

What do you guys think? Do I need RT? Pre Surgical PSA 20.

GLEASON SCORE - DOMINANT NODULE: 3+4=7, GRADE G
ROUP: 2, 30% PATTERN 4

GLEASON SCORE - SECONDARY NODULE: 3+3= 6, GRADE GROUP: 1

TUMOR EXTENT: Extensive

location (DOMINANT NODULE): Left;
Anterior/lateral/posterolateral/posterior; Apex/mid/base
Dominant nodule focally extends into Right; Anterior/lateral; Mid/base

location (SECONDARY NODULE): Right/Anterior/Apex

LOCAL EXTENT: Extraprostatic extension (Non-focal)
Left; Lateral; Mid/base

MARGINS: Negative

SEMINAL VESICLE INVASION: None

LYMPHATIC (SMALL VESSEL) INVASION: Absent

PELVIC LYMPH NODES (Includes all parts): All 8 lymph nodes are negative
for tumor

EXTENT OF INVASION (7th Edition, AJCC, Staging):

PRIMARY TUMOR: pT3a: Extraprostatic extension

REGIONAL LYMPH NODES: pN0: No regional lymph node metastases

SUMMARY MARGINS: Negative

TUMOR: A REPRESENTATIVE TUMOR BLOCK IS: LDA

NORMAL: A REPRESENTATIVE NORMAL BLOCK IS: REA

Note: Selected tumor slides were reviewed with Dr. Epstein.

So I can likely wait to see what psa does now and base RT off that. I know my pre surgery psa is a mitigating factor but maybe that can be cancelled out by some good (zero) PSA numbers going forward.

Overall I feel very lucky.

Tall Allen said...
Adjuvant RT would be jumping the gun, imho. To avoid overtreatment, you would be better off waiting to see what your uPSAs tell you.

Sounds good to me