Pathology Report is in--input?

stub1969

Hello everybody.  I've been waiting anxiously for this report and I need your help interpretting this.  I'm worried about the positive margins.  Any and all input is welcomed and appreciated.

 

Stub

 

DIAGNOSIS: A. Kidney, right, partial nephrectomy: Chromophobe renal cell carcinoma (5.3 cm in greatest dimension).

The renal parenchyma margin is positive for carcinoma. See synoptic report.

Synoptic Report Procedure: Partial nephrectomy.

Laterality: Right. Tumor Focality: Unifocal. Tumor Size: 5.3 x 5.2 x 4.1 cm.

Histologic Type: Chromophobe renal cell carcinoma.

Histologic Grade: Not applicable.

Macroscopic Extent of Tumor: Confined to kidney.

Microscopic Extent of Tumor: Limited to kidney.

Coagulative Necrosis: Absent.

Sarcomatoid Differentiation: Absent.

Surgical Margins: Positive: Renal parenchyma (partial nephrectomy only).

Non-neoplastic Kidney: Insufficient non-neoplastic kidney present (partial nephrectomy only) Pathologic Staging (AJCC, 7th edition): Primary tumor: pT1b

Regional lymph nodes: pNX Number examined (total): 0

Distant Metastasis: Not applicable.

 

 

Footstomper

Speaking as a Masters in Ancient History

All this confined to kidney, limited to kidney sounds great. No Metastasis sounds really good. 5.3 cm sounds on the biggish side of small.

I reckon thats a good report, but I really am more comfortable talking about the Goddess Isis or the collapse of the Roman republic.

icemantoo

Speaking as a Doctor of Law

Sounds like the jury found in your favor.

 

 

Icemantoo

rhominator

Don't be too worried

I too had positive margins after a radical nephrectomy (into the vena cava). It made me more at risk for future disease. I was NED for two over years while on Votrient. My last scan showed some new activity. Not too worried -- I have lots of treatment options.

Hoping you find peace of mind. You're in God's hands.

hardo718

My 2 cents worth

Overall, good, good and good.  My only concern is that darned positive margin, but what do I know?  Have you discussed this with your doctor yet?  

My advice would be to stay on top of your follow-ups.

I'll keep you in my prayers,

Donna~

 

stub1969

Actually

I sent in an electronic question through the portal that Mayo uses about my pathology report.  Late this afternoon, one of the doctors that was on my surgical team (He actually was the doctor that was on rounds and discharged me) called to visit about this.  He said visually the tumor was extracted but part of the margins on the tumor did have positive microscopic margins.  He felt that when they do the ablation or cauterizing of the kidney it killed all possible remaining cancer cells.  He did say they would have active surveillance with scans and blood work every three months for a couple years before moving to six month scans.  He said they do not recommend going back in to cut more out or removing the kidney.  So, I guess my anxienty with scans will really be up there. 

Stub

sblairc

Your case is uncommon here, and good news on chromophobe

I don't recall many cases of people on this site posting about positive margins following a partial and still being such a low stage tumor with no infiltration to other places.

The response from your surgical team was not what I would have expected (with all my internet medical training, LOL!!!). I guess I figured the'd go back in and take more of the kidney to achieve positive margins at some point. Perhaps because of having chromophobe (which is known in most cases to be rather "indolent" or "lazy" type of RCC) and they are confident they got it all (based on their knowledge of how extensive their work was to the remaining kidney inside)

Moral of the story, active surveillance will pick up anything else and then if they need to, it gets taken out again. Sucks, but you are NOT going to die from this kidney cancer. You are in REALLY good shape. With the subtype of your tumor being "lazy" (lesser likely to spread) and the stage being so low, and confined to the kidney, you have A LOT TO CELEBRATE!!! I hope you do. Have a great weekend. 

stub1969

Odds

Sure seems like I keep playing the wrong odds.  I have Medullary Sponge Kidney (bilateral) rare; Kidney cancer (rare), Chromophobe subtype (rare), now positive margins on a robotic partial (rare).  I'm getting tired of being on this side of the coin.  It's got to turn around--doesn't it?

Stub

PS--Thanks for the positive words and encouragement, sblairc

sblairc

stub1969 said:

Odds

Sure seems like I keep playing the wrong odds.  I have Medullary Sponge Kidney (bilateral) rare; Kidney cancer (rare), Chromophobe subtype (rare), now positive margins on a robotic partial (rare).  I'm getting tired of being on this side of the coin.  It's got to turn around--doesn't it?

Stub

PS--Thanks for the positive words and encouragement, sblairc

Your welcome. (husband 47 at diagnosis with chromopobe)

He'll be celebrating the big 50 in January. His was Stage 3, extensively necrotic so of course I worry all the time. But we've got too much to do this winter to let it get us down. We find planning things in advance (vacations and such) keeps us from stressing out too much with the scanxiety. 

stub1969

Similarities

I read your bio, but wasn't sure what age your husband was at diagnosis.  I just saw the age span and it was in 2014.  Besides our age at diagnosis, RCC type, our birthday month is January.  I'm hoping I follow suit with cancer free status.  Like I said--I feel really good about the pathology report except for the margins, but the doctor talked me through it, which helped.  I'm sure when those first scans are done, I'll be pretty anxious.

Take care and enjoy the long weekend--and again, thanks!

Stub

 

JerzyGrrl

stub1969 said:

Actually

I sent in an electronic question through the portal that Mayo uses about my pathology report.  Late this afternoon, one of the doctors that was on my surgical team (He actually was the doctor that was on rounds and discharged me) called to visit about this.  He said visually the tumor was extracted but part of the margins on the tumor did have positive microscopic margins.  He felt that when they do the ablation or cauterizing of the kidney it killed all possible remaining cancer cells.  He did say they would have active surveillance with scans and blood work every three months for a couple years before moving to six month scans.  He said they do not recommend going back in to cut more out or removing the kidney.  So, I guess my anxienty with scans will really be up there. 

Stub

Mayo's portal

I love those portals that many health groups / medical centers are using now.  It's a great way to get a question to the right person(s) and generally get a quick and thorough response.  What your surgeon shared sounds as though they're looking out for you on multiple levels, multiple ways. 

Scanxiety will probably try to raise its miserable head when the time comes.  Remind it that -- since it weighs less than 40 pounds -- it's gonna be fastened securely in a child restraint seat, in the BACK seat.  Oh, and bring us along for the trip. 

Jerzy