Evaluation of Your Radical Prostatectomy Specimen

A full evaluation of the removed prostate evaluates the effectiveness of the surgical procedure in achieving cure. A full evaluation also may yield prognostic information that may be of value predicting the chance of recurrence. If recurrence does occur, evaluation of the RP specimen may yield data that suggests that the recurrence is local (i.e., in the area immediately adjacent to the prostate) rather than distant.

Full RP evaluation includes the following elements:

Grading sizing and location of tumor(s).

Presence of extracapsular extention and status of surgical margins.

Estimated tumor volume.

Percentage of poorly differentiated tumor (Gleason pattern 4 and 5).

Perineural involvement.

Tumor markers (p27, p53, BCL-2)

DNA ploidy analysis

Evaluation of pelvic lymph nodes.

The ability of the pathologist to make a full evaluation depends to a large degree on the quality of  the disection of the prostate and the care the laboratory took in preparing the resulting glass slides. Generally, this crucial procedure occurs the day after surgery in the hospital where the surgery takes place. If a complete RP examination is important to you, please emphasize this point to the hospital pathologist. A valid estimation of tumor volume can be made only if most of the prostate has been sampled and diagrammed by the pathologist (See http://www.prostatelab.com/pathtech.htm).

Have the original lab send original slides or recuts of all RP specimen blocks.