O Stoma Mia wrote:KathyLynn wrote:I have a question, my report shows:
Question is.....a comment on my report..
“Since the focus of adenocarioma identified in one of fifteen lymph nodes is less than 0.2 mm in size, it is considered N0 for staging purposes"
Very confusing to me
Doctor suggested to see an oncologist to see what he may want to do with this
Anyone had this result?
I haven't had this result, but I think that this is covered in the detailed instructions that accompany the colorectal cancer pathology template. In that document they say that a single, small isolated .tumor deposit in a lymph node.has no prognostic value. In particular, in these cases they recommend coding this as pN0CS3.06e Recording small tumour deposits in lymph nodes needs to take account of the following issues:
* Isolated tumour cells are defined as “single malignant cells or a few tumour cells in microclusters”, not more than 0.2 mm in diameter, present within a lymph node. They may be single or multiple. They may be visible in H&E stained sections or detected by immunohistochemistry. The literature suggests that the finding of such cells is not a marker of an adverse prognosis for the patient.
"...The AJCC TNM 7th edition recommends that cases in which isolated tumour cells are the only form of nodal involvement should be classified as pN0, although the presence of the isolated tumour cells should be noted. Optional designation as pN0(i+) may be used in this situation, although a free-text description might provide clearer communication.
There are several scientific articles that they cite to support their recommendation to code the result this way.
If you want to see the source articles, let me know and I will try to dig up the references.
Essentially, what they are saying is that, all things considered, it is better to code this as T2N0M0 than T2N1M0, to avoid over-treating the patient and causing more harm than good. But you should discuss this with your oncologist to get a medical perspective on this.
So my oncologist seems to think that I should have Rad/chemo. The radiation scares me since I just had surgery. My surgeon is totally against radiation. Don’t you think this would be considered over treated?
Oncologist will bring it up next week at the board meeting.
Anyone have radiation after LARS?
I’m not having any issues with my bowels, I don’t want to have issues if it is not needed.