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Staging and percentages

User
Posted 06 Dec 2016 at 19:06
Just a little bit of help with my husband's results in terms of percentages....

results are targeted areaGleason score 6 (3+3) 2/4 cores 4% Gleason grade group 1
Random right PZ - Gleason score 7 (3+4) 1/5 cores 4% Gleason grade group 2

Grading is T2c as radiologist identified inflamation left lobe although biopsy in that targeted area are clear PSA 4.96

He was diagnosed with BPH 12 years ago, this was picked up on a rise to PSA which has always hovered below 4 but never really low. The proposed course of action is da Vinci assisted removal the T2c staging is a factor in that recommendation.
Not sure about the 4% we only got the print out after our discussion and just trying to make sense of it all - can anyone explain the %
Thanks

User
Posted 06 Dec 2016 at 20:43

Hello Sue,


There are now two ways of denoting the likely aggressiveness of prostate cancer: the traditional Gleason Grade (two numbers added together e.g. 3+3, 3+4, up to 5+5) and a newer "grading group" (Group 1 to Group 5). The "percentage" I expect is part of the new grading system and would refer to the percentage of irregular cells that was observed in the biopsy "slice."


Flexi

User
Posted 07 Dec 2016 at 10:18

Hi Sue,


Not sure if this helps.  I had <1% one lobe on my letter and 8% the other lobe.    Similar dx ish to your husband, although mine would be Graded 3, as (4 + 3) not (3 + 4), your husband on low risk end of scale.  (my PSA had been a little high for years) See notes in my profile.  Consultant more concerned with Grading rather than amount of tumourous cells.


You could query and question in more detail, location and size of lesion(s), as I never knew if mine was one lesion across both lobes or multifocal lesions.   Originally I thought erroneously all tumours were unifocal, seems PC is very complex.     


By brother in Australia (just dx) had a printout of every % in every core (and obviously you can't add together percentages)    


Each core from my understanding is about 1.2mm ish long -  ie The analogy of finding a 'rice' grain or smaller within an apple/orange etc etc by sticking straw in.   Not quite needle in haystack however not far off.     More of an 'art' than a science when you think about the variables involved.     As Lyn says - where are the cells positioned -- towards the outer edges  or not ?   Will there be clear margins ??  Huge assumptions in many ways when I think back to my one and only biospy.    That's why Gleason 6 / re. AS is in my opinion a tough call to make.  QoL versus cure.    You go with the flow in many ways and make the best informed decision.   I questioned my <1% at time as seemed a positive that so little tumour had been found, however we decided LRP within 3 months and post op it was discovered the capsule membrane/wall was just being transgressed, so again no idea if this took place in years, months or weeks. I guess a close call looking back.       


From my understanding the analysis will be based on :


millimeters of cancer per core, total millimeters of cancer among all cores, percentage of cancer per core, total percentage of cancer in the entire specimen, number of positive cores and fraction of positive cores (number of positive cores and total cores).


As you know, all very much hit and miss (excuse the pun) - as higher grade cells may be completely missed or cancer missed entirely.  I only know due to the extensive printout by brother was given (and he can view online) the detail he was given from his mpMRI scan nearly a year before.    


All the best , re your decision  


Gordon


 

Edited by member 07 Dec 2016 at 10:30  | Reason: Not specified

User
Posted 08 Dec 2016 at 08:48
When I received my results I got:-
Left 6/6 40% right 3/6 50%

That was 6 cores (samples) on each side, when I questioned the % figure they said that represented the highest % of cancer in any one core on that side.
 
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