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Post-Operative Management of Positive Apex Margins in Prostate Cancer Case

This case study focuses on a 59-year-old male with clinical T1c, Gleason 7 adenocarcinoma of the prostate, who underwent radical retropubic prostatectomy. Pathological findings revealed T2c disease with positive margins bilaterally at the apex. Following surgery, the patient's PSA levels were undetectable for two years, but subsequent monitoring showed a rise to 0.2 and then 0.3 ng/ml. The case highlights the importance of clinical considerations post-surgery and the need for targeted planning for treatment, emphasizing the CTV for the tumor/prostate bed.

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Post-Operative Management of Positive Apex Margins in Prostate Cancer Case

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  1. Post Op Positive Apex MarginsCase 3: Prostate_3 • Case 3 • A 59-year-old gentleman with a preop clinical T1c, Gleason 7 (3+4) PSA 12 adenocarcinoma of the prostate. He is status post radical retro pubic prostatectomy and found to have pathologic T2c, Gleason Score 7 (3+4) disease. Pathology reveals margins positive bilaterally at the apex. His PSA went to undetectable for 2 years then rose to 0.2 and 6 months later was 0.3 ng/ml. Please draw the CTV-TB (CTV for the tumor bed/prostate bed for this case). www.rtog.org www.rtog.org

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