Stage 2 vs Stage 3

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Nik Colon

Re: Stage 2 vs Stage 3

Postby Nik Colon » Thu Mar 17, 2016 8:00 am

Jacques wrote:
Nik Colon wrote:...
I found this, which may be why they said stage 3, but I would ask to clarify.

Problematic issues in N staging (see also miscellaneous issues below)
Direct invasion of a node by the carcinoma counts as nodal involvement
Only regional draining nodes count for N staging
Nodes draining other bowel areas count towards M staging
If the primary spreads longitudinally to an adjacent bowel area, nodes draining that area count towards N staging
Involvement only of afferent lymphatics in a node counts as pL1, not as pN1
Nodules in the extra-tumoral soft tissue, discontinuous from intramural carcinoma:
(If there is any evidence of residual lymph node, they should be considered nodal metastases)
They should be recorded as Tumor Deposits (pTD)
They are not counted as nodes
They do not constitute evidence of pT3
If no lymph nodes are involved by carcinoma, these tumor deposits qualify for pN1c
If nodes are involved, they are not designated pN1c and have no impact on TNM
pN1c affects the overall Stage Group in the same manner as pN1a and b
This applies only to deposits within the lymphatic drainage of the tumor
Thus Tumor Deposits function as nodal metastases in staging when they are needed, but do not contribute to your node count

http://surgpathcriteria.stanford.edu/gitumors/colorectal-adenocarcinoma/grading.html


Nik - Thanks very much for posting the link above. I think that this is a very important resource, because it shows very clearly that, from time to time, the TNM staging system needs to be supplemented by detailed analyses of the pathology report findings. This seems to be the case in the current diagnosis. It was also true in my owm case as well. Technically, I am classified as Stage II according to a strict interpretation of the TNM system, however, my doctor said that I was, in effect, equivalent to a Stage III, so that is why he insisted on having me do both adjuvant chemo/radiation plus adjuvant Xelox after my LAR surgery.

:D glad I could help

mike1965
Posts: 118
Joined: Mon Jan 25, 2016 11:07 pm

Re: Stage 2 vs Stage 3

Postby mike1965 » Fri Mar 18, 2016 7:33 pm

Thanks for all your input. Regardless of what the current stage is. It has shown me that I need to be much more aggressive in my approach toward this cancer. My first Surgeon was very lax and I was uneducated. That is now longer the case. I am upset he wasted valuable time with his lax approach. But I can not dwell on that and must move forward. I am going to do what ever it takes to battle the cancer with every tool and drugs that the doctors have.
Colonoscopy 09/06/15 Doctor removed polyp
DX - Rectal cancer 09/10/2015 T1M0N0
Surgeon recommended wait and see approach 09/2015
Tumor board recommended LARs Surgery 10/2015
Oncologist and PCP recommended LARs Surgery 11/2015
Seeking 2nd opinion from another Surgeon 01/2016
Having Sigmoidscopy on 02/01/16.
Figured out treatment 02/2016
LARS Surgery 03/2016
Stage 3A T1 N1C M0
Chemo Folfox to begin 04/18/16

Travelgirl
Posts: 123
Joined: Sun Dec 20, 2015 4:17 am
Facebook Username: Jac gar
Location: Florida

Re: Stage 2 vs Stage 3

Postby Travelgirl » Sat Mar 19, 2016 2:24 am

Hey mike,

Have you gotten copies of your medical reports and records from the doctors and hospitals?

The path report should give you the staging of what the surgeon removed.

I have all my medical records doctors and nurses notes. Do you also have a primary doctor other than the GI doctors and surgeons? They can also help you manipulate the medical lingo.

I took all my medical records to a primary doctor. He read through everything and helped me to feel better about what was going on. Plus this dr, is like having another pair of eyes in your treatments.

There is a post on here somewhere I saw, the person is NED with a stage IV cancer. It has been five years for him and he changed his lifestyle eating healthier and walking ten miles a day.

Hang in there my friend were all here for you if you need anything. Lots of knowledge based on personal experience.
Travel Girl
53/F
DX-CC 12/19/15
Tumor location Cecum
Tumor Type -Adenocarcinoma arising background sessile serrated polyp high grade dysplasia
Tumor size 1.5 cm
TNM - T1, N0, M0
Stage 1
Baseline 12/15 CEA 2.4, 8/16 CEA 1.7,11/15 CEA 2.3
Surgical Margins Clear
Lynch - Neg
Primary Surgery 1/11/16 LAR right colon and portion of ileum right hemicolectomy
1/4 follicular lymphoma- Wait n Watch (found in CT scan for Colon cancer) a 2 for 1 special.
8/16/16 NED for Colon/Lymphoma nodes have shrunk on their own.


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