The pathology report is one of the cornerstones determining your final diagnosis. It is used along with any scans that you have already had to determine your TNM code, which in turn is used to determine your stage. Once the doctors (surgeon, oncologist, gastroenterologist ) agree on what your stage is, then they can consult the NCCN "cookbook" of available first-line treatments for your final stage (
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) . The first-line treatment options may be different for rectal vs. colon cancer.
Before going to your Friday appointment, you should read up on TNM staging, since this is what the pathology report is mainly used for. You can review the various TNM codes and associated Stages here:
Colorectal cancer TNM stagingIt would also help if you could create a signature to go at the bottom of your posts so that everyone can see what your status is so far. The link for creating and editing a signature is here:
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Understanding Your Pathology Report: Colon Cancer
https://www.oncolink.org/cancers/gastrointestinal/colon-cancer/treatments/understanding-your-pathology-report-colon-cancer Path report -- what information is typically included?
http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=49195#p374408Here's a typical path report template:Path Report Template
Table 2
Surgically resected specimens of colorectal cancer – Checklist
Tumor site:
Cecum
Ascending colon
Hepatic flexure
Transverse colon
Splenic flexure
Descending colon
Sigmoid colon
Rectosigmoid junction
Rectum
Tumor size
Maximum tumor diameter: cm
Histologic type
Adenocarcinoma
Mucinous adenocarcinoma
Signet-ring cell carcinoma
Small cell carcinoma
Squamous cell carcinoma
Adenosquamous carcinoma
Medullary carcinoma
Undifferentiated carcinoma
Other (specify):
Grade of differentiation
Low grade (well or moderately differentiated)
High grade (poorly differentiated or undifferentiated)
High grade component (%):
Depth of tumor invasion
No evidence of primary tumor
Tumor invades submucosa (pT1)
Tumor invades muscularis propria (pT2)
Tumor invades through the muscularis propria into the subserosal adipose
tissue or the nonperitonealized pericolic or perirectal soft tissues (pT3)
Tumor penetrates to the surface of the visceral peritoneum (serosa)
(pT4a)
Tumor directly invades other organs or structures
(specify:) (pT4b)
Tumor penetrates to the surface of the visceral peritoneum (serosa) and
directly invades other organs or structures
(specify: ) (pT4b)
Margins of resection
Proximal/distal margin
Cannot be assessed
Invasive carcinoma present
Invasive carcinoma absent
Distance of invasive carcinoma from closest margin:
mm
Circumferential (radial) margin
Not applicable
Cannot be assessed
Invasive carcinoma present
Invasive carcinoma absent
Distance of invasive carcinoma from non-peritonealised margin:
mm
Regional lymph nodes
Number examined:
Number involved:
Tumor deposits
Not identified
Present (number: )
Response to neoadjuvant therapy
Not applicable (no prior treatment)
Complete regression
Minimal residual tumor
No marked regression
Extramural venous invasion
Not identified
Present
Pathologic staging (pTNM)
TNM descriptors
(required only if applicable)
m (multiple primary tumors)
r (recurrent)
y (posttreatment)
Primary tumor (pT)
pTX: Cannot be assessed
pT0: No evidence of primary tumor
pTis: Carcinoma in situ, intraepithelial or invasion of lamina propria
pT1: Tumor invades submucosa
pT2: Tumor invades muscularis propria
pT3: Tumor invades through the muscularis propria into pericolorectal
tissues
pT4a: Tumor penetrates the visceral peritoneum
pT4b: Tumor directly invades other organs or structures
Regional lymph nodes (pN)
pNX: Cannot be assessed
pN0: No regional lymph node metastasis
pN1a: Metastasis in 1 regional lymph node
pN1b: Metastasis in 2 to 3 regional lymph nodes
pN1c: Tumor deposit(s) in the subserosa, or nonperitonealized pericolic
or perirectal tissues without regional lymph node metastasis
pN2a: Metastasis in 4 to 6 regional lymph nodes
pN2b: Metastasis in 7 or more regional lymph nodes
Distant metastasis (pM)
Not applicable
pM1: Distant metastasis
Specify site(s):
pM1a: Metastasis to single organ or site (e.g., liver, lung, ovary,
nonregional lymph node)
pM1b: Metastasis to more than one organ/site or to the peritoneum
Additional pathologic findings
None identified
Diverticular disease, ulcerative colitis, Crohn’s disease, familial
adenomatous polyposis, other forms of polyposis, synchronous
carcinoma(s) (complete a separate form for each cancer), etc.
Specify:
Polyps present (specify type and number):
Comments
Reference:
Recommendations for the Reporting of Surgically Resected Specimens of Colorectal Carcinoma