Pathology Report

duster10

I wanted to once again thank you all for the support over the last month.  Every day I seem to learn a little bit more, and yesterday I had my meeting with the doc to review my pathology.  Here are the details....

 

Procedure: Radical nephrectomy

Tumor Size: Greatest Dimension= 10.6 cm

                   Additional Dimension= 9.8 cm

Macroscopic Extent of Tumor= Tumor limited to kidney

Histologic Type = Clear cell renal cell carcinoma

Sarcomatoid features= not identified

Necrosis = not identified

Fuhrman Nuclear Grade = G3

Margins = margins negative for invasive carcinoma

Lymphnodes removed = 6 ( all clear)

STAGING = pT3a

So, to summarize, looks like I am T3 based on the size, but currently cancer free!  I did ask the doc how long she thought the tumor had been there and she said.........8 years!  I know it was just a guestimate, but I was shocked.  The point of this post is to hopefully add some positive vibes to those who are diagnsed with a larger tumor (or any tumor).  The overall weight of my kidney was 1100 grams......I had to google it to see what that equated to in pounds, and that is 2.2 pounds.  Big tumor doesnt always mean it is the end of the world!  Took me a couple weeks to realize that, but hopefully it gives some of you STRENGTH!          

 

 

 

foroughsh

Mine was 10 cm too. Two years

Mine was 10 cm too. Two years ago and I've been NED since the surgery.

Just one question, how could it be T3a if it's confined to the kidney? As far as I know as long as the tumor is still confind to the kidney it's T2?

 

duster10

foroughsh said:

Mine was 10 cm too. Two years

Mine was 10 cm too. Two years ago and I've been NED since the surgery.

Just one question, how could it be T3a if it's confined to the kidney? As far as I know as long as the tumor is still confind to the kidney it's T2?

 

Im no expert

but I think the fact that it was over 10cm makes it T3?

foroughsh

http://m.cancer.org/cancer
http://m.cancer.org/cancer/kidneycancer/detailedguide/kidney-cancer-adult-staging
It is T2b if it's larger than 7 cm and still confined to kidney.
I would have asked my surgeon or oncologist if staging was correct. It's limited to the kidney, nothing about renal vein or fatty tissue's invasion is written , so logically it can be stage 2b.
By the way you can read the link.
Forough

Allochka

The fact that it was confined

The fact that it was confined to kidney is great! All the chances that surgery was a total cure. What is your planned follow up program?

todd121

duster10 said:

Im no expert

but I think the fact that it was over 10cm makes it T3?

T3 Grade 3

T3 but confined to kidney usually means it had invaded some of the veins in the kidney. That's what happened to me. My tumor was 6.9 cm, but because it had invaded the small veins (wasn't visible on the scan but showed up on the pathology) I was bumped from T1 to T3. Grade 3 and T3 bumps up the recurrence risk. It's more like 30-40% chance of recurrence.  You should be followed closely for the next 3 years at least and then on after that biannually. Make sure you get the extra scans for Stage 3 followup. For me it was CT of chest/abdomen and pelvis every 4 months for 1 year, then every 6 months after that to 3 years. However, because I had a recurrence after 2 years, I'm back to every 3 months now.

Wholly contained over 7cm, is normally T2. The main difference between T2 and T3 is the tumor infilitrated into veins or arteries nearby or in the kidney.

Regards,

Todd

Footstomper

foroughsh said:

http://m.cancer.org/cancer
http://m.cancer.org/cancer/kidneycancer/detailedguide/kidney-cancer-adult-staging
It is T2b if it's larger than 7 cm and still confined to kidney.
I would have asked my surgeon or oncologist if staging was correct. It's limited to the kidney, nothing about renal vein or fatty tissue's invasion is written , so logically it can be stage 2b.
By the way you can read the link.
Forough

Ah..

2b or not 2b? That is the question.

 

 

 

 

(Sorry)

todd121

Footstomper said:

Ah..

2b or not 2b? That is the question.

 

 

 

 

(Sorry)

Ha!

Or as a C programmer might say (2b || ~2b)

Sorry too.

todd121

foroughsh said:

http://m.cancer.org/cancer
http://m.cancer.org/cancer/kidneycancer/detailedguide/kidney-cancer-adult-staging
It is T2b if it's larger than 7 cm and still confined to kidney.
I would have asked my surgeon or oncologist if staging was correct. It's limited to the kidney, nothing about renal vein or fatty tissue's invasion is written , so logically it can be stage 2b.
By the way you can read the link.
Forough

T3 - Renal Vein

Any infiltration to certain types of veins in the kidney bumps the Stage to 3. The link you have above is slightly summarized in that area.

If you look at the detail of the pathology report, it will probably tell you that there was infiltration of certain types of veins and that's why its Stage 3 instead of Stage 2.

There's some more details staging information in some other places where they go into even more detailed. I couldn't find the best, but this one is slightly more detailed:

https://www.cancer.gov/types/kidney/hp/kidney-treatment-pdq

It states that T3a, if Tumor grossly extends into the renal vein or its segmental (muscle containing) branches.

On my pathology it talked about the tumor extending into muscled veins or something like that.

This is why it bothers me when we tell everyone on the board that if they have a small tumor on their scans, they have nothing to worry about. It's true a lot of the time, but not all of the time. I went from Stage 1 pre-surgery thinking I had a 90-95% cure, to Stage 3 post-surgery, finding out I had something like a 60-70% chance of a cure. It was a little unnerving. Size is only part of the story. We don't get the whole story until we have the pathology and you know the type, sub-type, grade, and stage all from the pathology report. Even a small tumor that is located in the center of the kidney can be Stage 3 and can be a very aggressive. Of course, it's best to encourage everyone not to worry until the information is available. Hope for the best is always the best choice of action.

Regards,

Todd

duster10

Allochka said:

The fact that it was confined

The fact that it was confined to kidney is great! All the chances that surgery was a total cure. What is your planned follow up program?

The follow up

plan is for scans every 3 months for two years, although they aid they may re-evaluate that after a year, assuming all scans are clear.  My first scan and bloodwork will be right before Christmas (Merry Christmas Duster).  My scan will be with contrast, and then they like to do a face to face when reviewing the scan with me.

I am sure the scans will lead to a high level of anxiety, but all things considered, I feel rather fortunate.

JerzyGrrl

Are you sure it's not...

At any rate, hope you get a visit from your Uncle Ned this December, bringing you a puppy. 

Jerzy

rhominator

todd121 said:

Ha!

Or as a C programmer might say (2b || ~2b)

Sorry too.

Nice. Reminds me...

There are 10 kinds of people in this world:

-- those who know binary

-- those who don't

-- those who know this is actually a tertiary joke.