Hai pump leak into lymph nodes

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mpbser
Posts: 751
Joined: Wed Apr 19, 2017 11:52 am

Hai pump leak into lymph nodes

Postby mpbser » Wed Mar 13, 2019 1:45 pm

So the flow scan test that was done yesterday showed leakage into liver lymph nodes. Dr. D’Angelica did not seem overly concerned but said that it is Dr. Kemeny’s call whether or not HAI pump chemo can be given with it as is. We don’t know if this is something that can be “repaired” as in removing the nodes and thus removing the condition that will lead to leakage. (For those unfamiliar with our story, he just had surgery last Thursday to implant the pump. Chemo scheduled to begin in April.) We don’t know what risks there may be if FUDR gets into these nodes. Any ideas?
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm T1 N0
CEA: 1.4, 2.1, 1.5, 1.9, 1.9, 2.1, 2.1, 2.4, 1.7, 2.0, 2.9, 2.2
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI shows met
Resection & HAI Mar 7

radnyc
Posts: 340
Joined: Tue Apr 06, 2010 6:32 pm

Re: Hai pump leak into lymph nodes

Postby radnyc » Wed Mar 13, 2019 6:07 pm

DX Jan '10, at 47
Feb - colon resection - 2/17 nodes
April - liver mets - Stage 4
3 months Folfox chemotherapy
August '10 liver resection and HAI pump
7 months chemo FUDR HAI and Folfiri systemic
NED since August 2010
Last treatment April '11
HAI Pump removed Dec '15

mpbser
Posts: 751
Joined: Wed Apr 19, 2017 11:52 am

Re: Hai pump leak into lymph nodes

Postby mpbser » Wed Mar 13, 2019 7:36 pm

Thanks for sharing that.
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm T1 N0
CEA: 1.4, 2.1, 1.5, 1.9, 1.9, 2.1, 2.1, 2.4, 1.7, 2.0, 2.9, 2.2
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI shows met
Resection & HAI Mar 7

boxhill
Posts: 189
Joined: Fri Apr 06, 2018 11:40 am

Re: Hai pump leak into lymph nodes

Postby boxhill » Thu Mar 14, 2019 10:46 pm

My eye was drawn to this because I've been trying to figure out whether the HAI pump would work on my 2 enlarged lymph nodes in the porta hepatis in addition to my tiny liver met, if keytruda doesn't work for me. I've been having a hard time finding information pertaining directly to treatment of such nodes. My oncologist considers them to be very risky to try to remove due to their location with no curative benefit in doing so, at least at this point. I am concerned that if they grow they will put pressure on the arteries/veins and bile ducts in the porta hepatis structure with obviously negative results. I know that stenting is possible, but finding some way to attack them directly the way HAI attacks liver mets would be awfully nice.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemicolectomy
11 of 25 nodes,5 of 5 mesentery nodes
0.5 cm sub-capsular liver met removed
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/4/18 FOLFOX
Neulasta 6/28/18
7/9/18 CT no masses or enlarged nodes, 2mm indeterminate lung nodule
11/20/18 CT same, Lung nodule likely calcified granuloma. Enlarged spleen.
12/20/18 Liver MRI 5mm liver met and 2 lymph nodes in porta hepatis, CT review shows progression of nodes on FOLFOX
12/31/18 Keytruda

mpbser
Posts: 751
Joined: Wed Apr 19, 2017 11:52 am

Re: Hai pump leak into lymph nodes

Postby mpbser » Sat Mar 16, 2019 9:26 am

I will keep you posted, boxhill. What we learn at our next appointment with his oncologist may be useful.
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm T1 N0
CEA: 1.4, 2.1, 1.5, 1.9, 1.9, 2.1, 2.1, 2.4, 1.7, 2.0, 2.9, 2.2
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI shows met
Resection & HAI Mar 7


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