Penetrates to the surface of the visceral peritoneum
All margins are free of tumor
Pathological stage: pT4a N0 Mx ...
Do we need to understand this report? Thank you for any information.....
Stage 2b was mentioned but not confirmed
I think it would help if you were to seek clarification for Stage 2b.
The AJCC staging manual for colorectal cancer was changed recently. In the earlier edition, Stage 2 had only two levels: Stage2a and Stage 2b. Now, the staging manual gives 3 levels for Stage 2: Stage 2a, Stage 2b, and Stage 2c. I assume that the pathologist is using the new staging system, in which case Stage 2b is in the middle of the Stage 2 range.
It might help to ask what the risk factors would be for a patient in your situation. The report says that there was penetration to the surface
of the visceral peritoneum, but it doesn't mention anything about attachment or adhesion of the tumor to adjacent organs or structures outside the colon. Nevertheless, it appears that the colon was somewhat perforated, and perhaps some cancer cells could have escaped through the perforation. But the report also said that all
margins were clear. A full pathology report will give three margins: near margin, far margin, and the radial (circumferential) margin. The problem might be with the radial margin (i.e., near the area where the penetration occurred). If the pathology report is complete and accurate, and if all
margins were in fact clear -- including the radial margin -- then it would mean that the margin around the tumor itself did not have any cancer cells either, which is good to know.
From my point of view, the concern might be that some cancer cells from the large T4 tumor could have escaped and might have fallen into the abdominal cavity. This might then lead to a later recurrence of peritoneal mets -- but I'm not sure about this at all. I'm not very familiar with this area.
In any event, what I would suggest is to ask the doctor whether a first-line chemo program would be effective in attacking cancer cells that might have fallen in the vicinity of the peritoneum.
It would also help if you could create a signature so that all your critical information is listed at the bottom of each of your posts. A link to the signature page is here:ucp.php?i=ucp_profile&mode=signature
Also do you have results from any scans of the liver or lungs? If so, this would clarify or update the Mx
in the path report