Is it good prognosis? even if only 2 of 5 lymph nodes are invaded by cancer cells and pericolic fat are invaded.
Cancer - 2 Answers
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1 :
When we resect a tumor, we make sure that grossly or macroscopically we stay away from the tumor cells. We make sure that both proximally and distally the resected margins are not invaded or involved. For, if they are involved grossly, then the resection isn't complete resulting in positive margins which is not good. We expect a negative margin after a decent surgical exercise. The pathology report which comes there after will say that the lines of resection are free of tumour. If only it was involved it will not heal well resulting in a leaking or leaked anastomosis(meaning intestine-intestine stitching line). Resection margins free of tumour means it is a good surgery. The prognosis depends upon the tumour biology i.e., whether it is a well differentiated, moderately differentiated or poorly differentiated adenocarcinoma. What is the NC ratio etc. Coming to the next half of your question, if only 2-5 nodes and pericolic fat are invaded what is the prognosis? Well, If the mesenteric lymph nodes are involved it is stage II. Modified Aster Coller Classification of Colonic tumors is as follows: Stage A: Only mucosa involved Stage B: Muscularis mucosa invloved Serosa not involved. Stage C: Serosa is involved breached. Stage D; Pericolic fat and Lymph nodal spread. Even though Mesocolic lymph nodes are involved, still the prognosis is quite good for Colonic Cancers unlike other cancers. They are generally slow growing. There is good chemotherapy like FOLFOX regime after surgery, which gives good results. There are higher chemotherapeutic regimes as well. It depends on your oncologist, which chemotherapy regimen he will choose for you. In FOLFOX there is no much hair loss also. Tolerated very well. However, If the treatment is taken to its logical end, Prognosis is really good in Colonic Cancers. Best of luck.
2 :
Your doctor should have gone over these results with you so you would know what it means and they should have also discussed prognosis as it pertains to your case specifically. I have never seen a pathology report written this way, but it means the margins are clear and if they were not it would not mean there would be leaking. Although having clear margins is good you cannot determine prognosis by it. A minimum of 12 nodes should have been sampled, but based on what you are stating this is a stage 3B with a 5 year survival rate of 56%.
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