The Colon Club

My report from my oncologist to my GP
Originally was T3N2MO ( 6LYMPHS AFFECTED)

Clinical stage prior to surgery was T3N1NO (after NACR) 1 lymph still left affected....

Pathology now YpT2 N1A M0( after SURGERY)
can someone explain this to me please???
Thanks ADELE

I could be wrong here so someone feel free to correct me if I am but from my understanding, the pathological staging refers to the staging of what they found when they did surgery—so it sounds like they went in there and removed the tumor that at this point was a T2 (shrunken from a T3 after your radiation) and they removed between 1-3 cancerous nodes (N1) and likely several others that were non cancerous but probably used to be back when you were N2.

Thanks punky,
but would you know what the abbreviation or YP is???
I don't see the point of restaging but maybe I'm uneducated in this area, and there may be a likely reason
I'm assuming bthe accurate report is the original one at DX?????
And it was originally moderately differencated at biopsy,,,,
Then poorly
And now moderately again at pathology???
More confusing???
As if it's not difficult enough to study lol
Thanks Adele

The "y" designator means after chemoradiation

the p means "pathological," in other words, a direct look at the specimen.

So, you would look at it like this:

Upon initial clinical evaluation (i.e. scans, ultrasound etc) your tumor was staged T3N2MO

You underwent chemoradiation prior to surgery, which adds the "y."

If they scanned you prior to surgery, then you would see something like ycTxNXMX with the "c" meaning "clinical."

After surgery, the specimen was sent to Pathology to be directly examined, which adds the "p."

So, after treatment and surgery, you were staged as ypT2N1AMO.

So, either chemoradiation downstaged your tumor depth, or it was over staged on clinical evaluation.

Hope this helps.

What SurvivorSpouse said!

Thanks lads, that explains it perfect
Adele X

Eleda wrote:
it was originally moderately differencated at biopsy,,,, Then poorly - And now moderately again at pathology??? More confusing???

When hubby was diagnosed, I was ‘praying’ for some good signs/test results. (I have stopped praving now.. it’s not me.. and it doesn’t work for me)
Anyway, after hoping/praying without success(!) for ‘benign tumor’.. then please not stage IV.. then please not Kras mutant... then please MSI..
Then suddenly I saw that the Grade had changed! It had changed from G3 at biopsi to G1 at pathology (after resection). I thought Yes!! finally something that sounds good that I can mention/ask about at the Onc appointment with DH. (I did not want ask about stuff I knew was ‘not good’). DH’s Onc replied: “that does not matter since he is stage IV”. Sigh Yes I understand that now.. but didn’t at the time.
As I understand it you have no metastasis so this might make a difference to you? Please ask your doctor.
Yes all this is confusing and maybe hard to answer ‘for sure’.
I wish you all the best!

Hi Eleda, hopefully you reports are way more positive than orignally thought. Its good to see you are getting hepl from poeple who have good knowledge. Keep it lit celtic friend !

Yes, what SurvivorsSpouse said is correct, but I have a couple of points to add:

Technically speaking, your staging after surgery can be represented in any of three ways, either:

1: ypT2 N1A cMO

or

2: ypT2 N1A MX

or, simply

3: ypT2 N1A

The point at issue is the "M" component of the TNM scaling. When a pathologist receives the specimen from a colorectal resection, he/she receives the resected primary tumor and the block of nearby lymph nodes, which will allow him/her to assess the "T" and "N" components of the TNM scale. He/she does not usually receive any tissue specimen that would allow the "M" component to be assessed. Thus, the pathologist has three options for reporting the findings. In Option 3, the M component is simply ignored because the pathologist has no information on it. In Option 2, the designation "MX" is used, which signifies "Metastasis cannot be measured". In Option 1, the lower-case "c" prefix is used to indicate that there is indeed information in the patient's file about the "M" component, but it comes from an independent, clinical, source (e.g., CT scan report).

One thing you could do is to ask your doctor about the "M0" in your current staging. Where did it come from? From a CT scan? If so, how old was the CT scan, and when are they planning to do a new, up-to-date one?

Thanks OSM, The MO was on the paragraph with the original DX, it's a short report sent to my GP so not much detail I. It, I can't upload a pic otherwise u could read it urself!!


DIAGNOSIS
1 Yp2 N1a rectal carcinoma

BACKROUND HOSTORY
1 low rectal cancer, clinically staged T3N1 at least treated with long course radiation fini9th Feb 2018.
2 surgery with laparoscopic low anterior resection and cooanal anastomosis preformed may 10th2018. Pathology consistent with yT2N1. 1/20 lymph nodes positive for moderately differencated andeocarcinoma RO resection. Mandrad regression grade 4 or cancer greater than fibrosis.
3 CT Scan April negative
4 MRI SCAN June no new dieease, no breach of anastomosis
5 MMR Intact
6 Adjuvant FOLFOX treatment
7 CT TAP OCT 15 NORMAL

THIS IS THE REPORT WORD FOR WORD,,,
THANKS ADELE X

MC Pudd,
I would be lost without the people on this page, because mostly people don't have the knowledge on any of this and I crave information so if I don't know
I can't sleep till I do, so I will be forever grateful for the support Vive been given here!!!

Great to see Ur still active, how r u doing ATM??? Hope as well as can be my Celtic friend

ADELE X

Good to hear from you Eleda, I've been up and down this last while, hard tl stay positive, some teeth broke broke and some loose also one side of face twitching. Short time memroy poor. Still walkin 5 or 6 times a week and was very bold saturday drank bottle of wine because i am a . Its great to hear from you, hope you are good, and if I can tell you anything positive its that i an now 4 yrs clear of bowel cancer, it is beatable. Its just a pify i have the gbm4. Hope we talk again soon I will try to engage in the forum more often.