Pathology report -- what information does it typically inclu

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lpas
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Joined: Wed Nov 19, 2014 11:11 pm

Pathology report -- what information does it typically inclu

Postby lpas » Fri Dec 19, 2014 11:27 pm

Does anyone know what kinds of analyses are typically included in a pathology report (for an initial colectomy)? After a long delay, I finally have a tentative surgery date, set for the week after Christmas. Is there anything in particular that I should be asking that them to look at?

Thanks
Last edited by lpas on Wed Mar 11, 2015 8:52 pm, edited 1 time in total.
11/14 Dx sigmoid CC @ 45yo
12/14 Colectomy + hysterectomy
Stage IIIB, T3N1bM0, 2/20 nodes, MSS, G2, KRAS(A146T), TP53, SMAD4, ERBB2, CEA 1.0
2/15-7/15 XELOX & celecoxib
2/19 clean scope
11/19 clean CT
Ongoing celecoxib, cimetidine & other targeted supplements
Mom to a 5 & 8yo

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O Stoma Mia
Posts: 1600
Joined: Sat Jun 22, 2013 6:29 am

Re: Path report -- what information is typically included?

Postby O Stoma Mia » Sat Dec 20, 2014 3:17 am

lpas wrote:Does anyone know what kinds of analyses are typically included in a pathology report (for an initial colectomy)? ... Is there anything in particular that I should be asking that them to look at? Thanks


Here is some information from the Royal College of Pathologists of Australasia on pathology reporting standards. I think the standards would probably be much the same for your situation.

Colorectal Cancer Structured Reporting Protocol

What I would suggest is that you read the relevant sections of this report, particularly the part on the structured checklist, which itemizes the kinds of things that are expected to be included in the pathology report. The checklist starts on page 41, then on page 66 there is an example of what a pathology report should look like.

One thing that I would ask your doctors -- well before the surgery date if possible-- is whether they are planning to do any genetic testing on the resected sample. These are the tests for such things as KRAS or BRAF genetic mutations, or the test called "Microsatellite Instability (MSI)", which will give information on other things, such as Lynch Syndrome (see pages 32 and 35 of the report). These tests might not be part of the standard pathology report where you are located and might need to be ordered separately. (EDIT: Or, it looks like this might already have been done on the biopsy from your colonoscopy.)

There are other types of tests that could be done on the specimen which might require a different or special way of storing the sample. One of these is the OncotypeDX report that is used to determine whether a patient might or might not benefit from certain types of chemotherapy. This type of test is usually used for Stage II or Stage III patients, where a patient might want to opt out of chemo altogether if the tests show only marginal possible benefit for chemo.

If you have time, you should try to understand the technical terminology used in the report. Particularly important is the Tumour Type (e.g., Adenocarcinoma, etc.), and Histological Grade, since these determine whether you have an aggressive type of cancer or not.


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