skb wrote:Online scientific papers do not have a clear recommendation. Some predict poor prognosis. Some predict good prognosis.
It all depends on the metastatic qualities of your cancer, situation and prior treatment. 4 years is a positive aspect.
A solitary node, or even a single site, has statistical odds of curative surgical success if more metastases are not occurring and/or circulating. Basically, conventional chemo has a very limited range of control for cancer in the lymph nodes, with mostly eventual failure. So surgery, while potentially curative alone or in combination, is conventionally considered useless if there is metastatic circulation, or spread beyond one site.
In 2011, recognition of curative surgery for solitary or confined lymph nodes was a brand new thing. In 2010 I had realized this possible
situation at the outset - she had what turned out to be a conglomerated, para-aortic lymph node cluster, eager to spread. So we kept my wife on the most active daily
chemo we could conjure up for her cells for the first year after her first surgery, and thus, hopefully, no additional escape and mets. In 2011, I encouraged surgeons to consider that her lymph nodes were a controlled, single site (controlled but maybe not so single a met site) but most weren't very interested LN dissection. Finally, I turned one "no" to a "yes" with an ex-MDA thoracic surgeon, then went upscale hospital-wise, and got a better offer from another surgical team.
Her second surgery was not really curative but still great progress; the pathology showed the cancer filaments were bursting out of the lymph node walls as well as shot through the chain of lymph nodes. The surgeon was so alarmed that he was insisting on her restarting chemo 5 days after surgery (vs the usual 2-6 weeks).
Faster on the draw, we had gotten her chemo re-started after 1 day (we were willing to bend the rules, by more technical means). It still took us 7 years of chronomodulated, immunochemo to burn the rest out. Fortunately that personalized approach to chronomodulated, immunochemo allowed less wear and tear on the body (and wallet), with a more cidal action on her cancer cells.