camicom wrote:Hello all, its been a while since I posted. I had an extended right hemicolectomy on 7/19 to remove a 5cm mass from my TC. It was originally supposed to be done by robot, but they had to convert because of its locations. They took 2/3 of my colon. The surgery lasted approx 2 hours and everything went well. The mass was only 2.6cm and all margins were clear. My hospital stay was 3 days, and just had my first firm bm. Got the path report back as follows
Stage 3a with only one the primary lymph node involved
They took a total of 48 LN.
The surgeon recommended a 3 month chemo. He told me my 5 year DF would go from 40-80% with chemo. Those statistics are incorrect.
Here are my thoughts after much research. I have put some much time researching this over the last couple months and in the last 7 days I have found many studies that say, Stage 3a with only the primary LN involved is different that regualr Stage 3a's. I found found at least 2 studies that show curative surgery is just as succesful in 5 year DF as 2 chemo options. Not only that but I have used the different cancer survival calculators by the CLeveland Clinic, Sloan, and MD ANderson that show 5 y rates with or with chemo and it shocked me with the below results. The calculators are very specific age, location CEA level, pos LN, total taken lymph nodes etc
https://www.mskcc.org/nomograms/colorec ... robability
5 year disease free after surgery with no chemo 79%
5 year disease free after surgery with chemo 78%
Cleveland Clinic Calc confirms Sloans numbers
http://riskcalc.org/ColorectalCancer5an ... eSurvival/
No Chemo 81%
I think the total amount of nodes taken play into these numbers.
At this point I am leaning against doing chemo, and staying with a anti inflammatory diet that I have successfully for the last 2 months. I would very much like you thoughts and suggestions, and your experience with short similar chemo cycles.
boxhill wrote:Personally, if it's in a lymph node, I'd do the chemo. Definitely.
The question may be: which chemo? What are your tumor genetics? I'd be discussing what regimen and why with my oncologist. Ask him/her if you are a type known to be poor responders to certain basic drugs.
BTW, I noted this language on the MSK site "Note: Results produced by this tool are based on data from patients treated from 1990 to 2000, when fluorouracil was the only active agent in adjuvant chemotherapy for colon cancer."
kaloy85 wrote:isn't it T3N1 is stage 3B, not 3A (T1-T2/N1, T1/N2a)?
camicom wrote:kaloy85 wrote:isn't it T3N1 is stage 3B, not 3A (T1-T2/N1, T1/N2a)?
pT3pn1a is on the report.
Rock_Robster wrote:I’m not sure I’d be relying on those calculators for this decision - the Cleveland Clinic tool also uses a dataset from 1990-2000; ie from up to almost 30 years ago!
This paper released in Feb this year suggests a 20-25% improved 5-year survival from chemo for Stage III patients; I realise there is still stratification within this group of course.
https://link.springer.com/chapter/10.10 ... 01165-9_33
Great news that you don’t have to worry about a BRAF mutation. Another other question to consider in this - did your primary tumour have any higher risk factors such as EMVI+, LVI or PNI?
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