Partial Pathology

MDCinSC
MDCinSC Member Posts: 574

I live too far away to get a full report in my hand for a few days BUT here is the news as reported this morning:

Clear Cell Renal Carcinoma; Negative Margins; Fully encapsulated.  No lymphs taken.  Awaiting word on staging!

Follow up every 3 months with a CT yearly til further notice!

 

I think I'll take it!

 

As I get more information, I'll post it!

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Comments

  • Galrim
    Galrim Member Posts: 307
    So far so good (you know what I mean)

    Staging sounds like stage 1 or 2 (Guessing that since no lymph nodes were removed).

    You didnt get any info on the grading?

    The follow up scheme sounds a bit odd though, 3 months check with 12 month ct scan?

    /G

  • MDCinSC
    MDCinSC Member Posts: 574
    Galrim said:

    So far so good (you know what I mean)

    Staging sounds like stage 1 or 2 (Guessing that since no lymph nodes were removed).

    You didnt get any info on the grading?

    The follow up scheme sounds a bit odd though, 3 months check with 12 month ct scan?

    /G

    That was the phone call!

    I've called back for more information, but like you I would guess T1b; somewhere between 4 cm and 7 cm.  They said looking at the lymph nodes they decided not to take them.

    They didn't ask me!  LOL

    As far as the follow up- it is the VA.  I don't know the rationale!

  • Texas_wedge
    Texas_wedge Member Posts: 2,798
    MDCinSC said:

    That was the phone call!

    I've called back for more information, but like you I would guess T1b; somewhere between 4 cm and 7 cm.  They said looking at the lymph nodes they decided not to take them.

    They didn't ask me!  LOL

    As far as the follow up- it is the VA.  I don't know the rationale!

    A result!

    Thank goodness you've taken the potion again and changed back into your old, handsome self!!

    Pity that we've lost sight of your Wife, though  :(

  • MDCinSC
    MDCinSC Member Posts: 574

    A result!

    Thank goodness you've taken the potion again and changed back into your old, handsome self!!

    Pity that we've lost sight of your Wife, though  :(

    Temporary condition!

    I'll be putting more up.  She is veryeasy on the eye!

     

    Thanks to all of you for your care and comfort!  Time to pay it forward!

  • Galrim
    Galrim Member Posts: 307
    MDCinSC said:

    That was the phone call!

    I've called back for more information, but like you I would guess T1b; somewhere between 4 cm and 7 cm.  They said looking at the lymph nodes they decided not to take them.

    They didn't ask me!  LOL

    As far as the follow up- it is the VA.  I don't know the rationale!

    Congratulations...

    ...on a tumor is an odd thing. But as RCC's go a T1b is a good thing.

    Crossing my fingers for you also getting a low grade.

    /G

    Ps. Im totally with Texas on the picture thing :-)

  • MDCinSC
    MDCinSC Member Posts: 574
    Hot off the presses!

    HISTOPATHOLOGICAL DIAGNOSIS:

          

           A. RADICAL NEPHRECTOMY:

              1. Specimen Laterality: Right. 

              2. Tumor Site: Lower pole. 

              3. Tumor Size:

                 a. Greatest Dimension: 4.5 cm. 

                 b. Additional Dimensions: 4.0 x 3.6 cm. 

              4. Tumor Focality: Unifocal. 

              5. Macroscopic Extent of Tumor: Limited to kidney. 

              6. Histologic Type: CLEAR CELL RENAL CELL CARCINOMA. 

              7. Sarcomatoid Features: Not identified. 

              8. Tumor Necrosis: Not identified. 

              9. Histologic Grade: G3: Nuclei very irregular, approx. 20 um;

          nucleoli large and prominent. 

             10. Microscopic Tumor Extension: Limited to kidney. 

             11. Margins: Uninvolved by invasive carcinoma. 

             12. Lymph-Vascular Invasion: Not identified. 

             13. Lymph Nodes:

                 a. Number of lymph nodes examined: 0. 

                 b. Number of lymph nodes involved: 0. 

             14. Pathologic Findings in Non-neoplastic Kidney:

                 a. Significant pathologic alterations:

                    1) Vascular disease (mild arterionephrosclerosis). 

             15. Pathologic Staging: pT1b, NX, MX. 

  • MDCinSC
    MDCinSC Member Posts: 574
    Galrim said:

    Congratulations...

    ...on a tumor is an odd thing. But as RCC's go a T1b is a good thing.

    Crossing my fingers for you also getting a low grade.

    /G

    Ps. Im totally with Texas on the picture thing :-)

    Back by popular demand!

    My picture with the beautiful woman sho shares my life, though heaven knows why!  Lucky I guess!

  • Galrim
    Galrim Member Posts: 307
    MDCinSC said:

    Hot off the presses!

    HISTOPATHOLOGICAL DIAGNOSIS:

          

           A. RADICAL NEPHRECTOMY:

              1. Specimen Laterality: Right. 

              2. Tumor Site: Lower pole. 

              3. Tumor Size:

                 a. Greatest Dimension: 4.5 cm. 

                 b. Additional Dimensions: 4.0 x 3.6 cm. 

              4. Tumor Focality: Unifocal. 

              5. Macroscopic Extent of Tumor: Limited to kidney. 

              6. Histologic Type: CLEAR CELL RENAL CELL CARCINOMA. 

              7. Sarcomatoid Features: Not identified. 

              8. Tumor Necrosis: Not identified. 

              9. Histologic Grade: G3: Nuclei very irregular, approx. 20 um;

          nucleoli large and prominent. 

             10. Microscopic Tumor Extension: Limited to kidney. 

             11. Margins: Uninvolved by invasive carcinoma. 

             12. Lymph-Vascular Invasion: Not identified. 

             13. Lymph Nodes:

                 a. Number of lymph nodes examined: 0. 

                 b. Number of lymph nodes involved: 0. 

             14. Pathologic Findings in Non-neoplastic Kidney:

                 a. Significant pathologic alterations:

                    1) Vascular disease (mild arterionephrosclerosis). 

             15. Pathologic Staging: pT1b, NX, MX. 

    More rigths than wrong.

    Lower pole, contained, clear margins. Focus on all the positive aspects and not the one negative one. Dont let that one down you now, when you have coped so seemingly positive with all of this. Okay?

    Have a good and detailed walkthrough with an oncologist about all of it, and scrutinize a bit about your future control regimes given the grade. Thats the best advise I can give. That and sending positive thoughts in your direction (for what its worth).

    /G

  • Djinnie
    Djinnie Member Posts: 945
    MDCinSC said:

    Hot off the presses!

    HISTOPATHOLOGICAL DIAGNOSIS:

          

           A. RADICAL NEPHRECTOMY:

              1. Specimen Laterality: Right. 

              2. Tumor Site: Lower pole. 

              3. Tumor Size:

                 a. Greatest Dimension: 4.5 cm. 

                 b. Additional Dimensions: 4.0 x 3.6 cm. 

              4. Tumor Focality: Unifocal. 

              5. Macroscopic Extent of Tumor: Limited to kidney. 

              6. Histologic Type: CLEAR CELL RENAL CELL CARCINOMA. 

              7. Sarcomatoid Features: Not identified. 

              8. Tumor Necrosis: Not identified. 

              9. Histologic Grade: G3: Nuclei very irregular, approx. 20 um;

          nucleoli large and prominent. 

             10. Microscopic Tumor Extension: Limited to kidney. 

             11. Margins: Uninvolved by invasive carcinoma. 

             12. Lymph-Vascular Invasion: Not identified. 

             13. Lymph Nodes:

                 a. Number of lymph nodes examined: 0. 

                 b. Number of lymph nodes involved: 0. 

             14. Pathologic Findings in Non-neoplastic Kidney:

                 a. Significant pathologic alterations:

                    1) Vascular disease (mild arterionephrosclerosis). 

             15. Pathologic Staging: pT1b, NX, MX. 

    Hi Michael, You received your

    Hi Michael, You received your results very quickly, your results pretty much match mine. I am not sure how they view a grade 3 in the States. However my surgeon has stressed that the tumour was fully encapsulated and the grade would be a concern if the margins were not clear. Galrim's comments have left me wondering.

     

    Djinnie

  • foxhd
    foxhd Member Posts: 3,181
    Djinnie said:

    Hi Michael, You received your

    Hi Michael, You received your results very quickly, your results pretty much match mine. I am not sure how they view a grade 3 in the States. However my surgeon has stressed that the tumour was fully encapsulated and the grade would be a concern if the margins were not clear. Galrim's comments have left me wondering.

     

    Djinnie

    Let me ask

    Are you smiling? Nice reort. God bless you. It's the report we all wish we could have gotten.  Keep up with follow ups.

  • MDCinSC
    MDCinSC Member Posts: 574
    foxhd said:

    Let me ask

    Are you smiling? Nice reort. God bless you. It's the report we all wish we could have gotten.  Keep up with follow ups.

    Its the report I wish I could

    Its the report I wish I could share with all of you!  You guys were there when we didn't know what it would be.   You educated me, sustained me, cheered me up and kept me in the fight.

    I have a lot of passing the peace on down to do.  I'm here for the long haul!

    God bless each one of you!

  • MDCinSC
    MDCinSC Member Posts: 574
    Djinnie said:

    Hi Michael, You received your

    Hi Michael, You received your results very quickly, your results pretty much match mine. I am not sure how they view a grade 3 in the States. However my surgeon has stressed that the tumour was fully encapsulated and the grade would be a concern if the margins were not clear. Galrim's comments have left me wondering.

     

    Djinnie

    Frankly, me too!  I'll take

    Frankly, me too!  I'll take this report and run with it!

  • Djinnie
    Djinnie Member Posts: 945
    MDCinSC said:

    Frankly, me too!  I'll take

    Frankly, me too!  I'll take this report and run with it!

    Good for you!! I think it's a

    Good for you!! I think it's a report to be welcomed with a big sigh of relief, congratulations Michael!

     

    Djinnie  x

     

  • Galrim
    Galrim Member Posts: 307
    Djinnie said:

    Hi Michael, You received your

    Hi Michael, You received your results very quickly, your results pretty much match mine. I am not sure how they view a grade 3 in the States. However my surgeon has stressed that the tumour was fully encapsulated and the grade would be a concern if the margins were not clear. Galrim's comments have left me wondering.

     

    Djinnie

    Just to clarify Djinnie, so...

    ...no one worries without reason. My comment to Michael was that, as histologys go, he more or less couldnt have gotten a better outcome of it all. And that the fact that only one prognostic factor wasnt excellent shouldnt throw him off his feet :-)

    But to answer more directly to your question regarding grading:

    As a single prognostic factor, if you ignore all others, it is a heavy weighing factor.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1471767/

    Quoting from that:

    "Tumor grade is an independent prognostic indicator for RCC. The Fuhrman nuclear grading system projects 5-year survival rates of 89%, 65%, and 46% for grades 1, 2, and 3 to 4, respectively, independent of T stage. Alternatively, in patients with T1 disease, 5-year cancer-specific survival rates have been reported to be 91%, 83%, 60%, and 0% for grades 1, 2, 3, and 4, respectively."

    Additionally, if you look at a often used prognostic model (exists in several variants but is overall the same):

    image

    But, and I cant stress this enough: THE STATISTICAL MEDIAN ISNT KING!

    Your individual situation and outlook is a combination of a lot of factors, relating only to you. So dont be alarmed or conclude anything regarding your own case based on the above. That information is based on overall statistics of thousands of cases, not you.

    Talk to your oncologist about it if any doubts. Im not a doctor, no one in here is. Just providing and sharing information to digest, and then pursue if you think it makes sense.

    As for how it affects the control regimes in various countries, I can only relate to my own country where grade 3/4 normally results in a higher control frequency, disregarding the stage.

    /G 

     

     

     

     

     

     

     

     

  • Djinnie
    Djinnie Member Posts: 945
    Galrim said:

    Just to clarify Djinnie, so...

    ...no one worries without reason. My comment to Michael was that, as histologys go, he more or less couldnt have gotten a better outcome of it all. And that the fact that only one prognostic factor wasnt excellent shouldnt throw him off his feet :-)

    But to answer more directly to your question regarding grading:

    As a single prognostic factor, if you ignore all others, it is a heavy weighing factor.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1471767/

    Quoting from that:

    "Tumor grade is an independent prognostic indicator for RCC. The Fuhrman nuclear grading system projects 5-year survival rates of 89%, 65%, and 46% for grades 1, 2, and 3 to 4, respectively, independent of T stage. Alternatively, in patients with T1 disease, 5-year cancer-specific survival rates have been reported to be 91%, 83%, 60%, and 0% for grades 1, 2, 3, and 4, respectively."

    Additionally, if you look at a often used prognostic model (exists in several variants but is overall the same):

    image

    But, and I cant stress this enough: THE STATISTICAL MEDIAN ISNT KING!

    Your individual situation and outlook is a combination of a lot of factors, relating only to you. So dont be alarmed or conclude anything regarding your own case based on the above. That information is based on overall statistics of thousands of cases, not you.

    Talk to your oncologist about it if any doubts. Im not a doctor, no one in here is. Just providing and sharing information to digest, and then pursue if you think it makes sense.

    As for how it affects the control regimes in various countries, I can only relate to my own country where grade 3/4 normally results in a higher control frequency, disregarding the stage.

    /G 

     

     

     

     

     

     

     

     

    Appreciate the information

    Hi Galrim,

    Thank you for taking the trouble to post that detailed information, that is very helpful. I know that there is no hard and fast rule with this cancer. I was just interested in the differing interpretations, as my surgeon here in France felt the grade was not so significant. They are doing a regular 6 monthly check up though.

    Thanks again.

     

    Djinnie

  • Galrim
    Galrim Member Posts: 307
    Djinnie said:

    Appreciate the information

    Hi Galrim,

    Thank you for taking the trouble to post that detailed information, that is very helpful. I know that there is no hard and fast rule with this cancer. I was just interested in the differing interpretations, as my surgeon here in France felt the grade was not so significant. They are doing a regular 6 monthly check up though.

    Thanks again.

     

    Djinnie

    No problem at all Djinnie

    Im just one of those horrible patients who annoy his doctors because he has read 1000+ pages on his own disease :-) Might as well put all those saved links and information to use in here, as long as people just remember to digest it and make their own opinion, and not take what I or anyone post as a final conclusion to anything regarding their own case.

    /G

  • Djinnie
    Djinnie Member Posts: 945
    Galrim said:

    Just to clarify Djinnie, so...

    ...no one worries without reason. My comment to Michael was that, as histologys go, he more or less couldnt have gotten a better outcome of it all. And that the fact that only one prognostic factor wasnt excellent shouldnt throw him off his feet :-)

    But to answer more directly to your question regarding grading:

    As a single prognostic factor, if you ignore all others, it is a heavy weighing factor.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1471767/

    Quoting from that:

    "Tumor grade is an independent prognostic indicator for RCC. The Fuhrman nuclear grading system projects 5-year survival rates of 89%, 65%, and 46% for grades 1, 2, and 3 to 4, respectively, independent of T stage. Alternatively, in patients with T1 disease, 5-year cancer-specific survival rates have been reported to be 91%, 83%, 60%, and 0% for grades 1, 2, 3, and 4, respectively."

    Additionally, if you look at a often used prognostic model (exists in several variants but is overall the same):

    image

    But, and I cant stress this enough: THE STATISTICAL MEDIAN ISNT KING!

    Your individual situation and outlook is a combination of a lot of factors, relating only to you. So dont be alarmed or conclude anything regarding your own case based on the above. That information is based on overall statistics of thousands of cases, not you.

    Talk to your oncologist about it if any doubts. Im not a doctor, no one in here is. Just providing and sharing information to digest, and then pursue if you think it makes sense.

    As for how it affects the control regimes in various countries, I can only relate to my own country where grade 3/4 normally results in a higher control frequency, disregarding the stage.

    /G 

     

     

     

     

     

     

     

     

    Information

    The graph would be useful information to have access to on this site.

    Djinnie

  • Djinnie
    Djinnie Member Posts: 945
    Galrim said:

    No problem at all Djinnie

    Im just one of those horrible patients who annoy his doctors because he has read 1000+ pages on his own disease :-) Might as well put all those saved links and information to use in here, as long as people just remember to digest it and make their own opinion, and not take what I or anyone post as a final conclusion to anything regarding their own case.

    /G

    Information

    Hi Galrim,

    I appreciate you being on here, I glean more information from you than the Doctors. It gives us something to work with.

    Thanks again

    Djinnie

  • Galrim
    Galrim Member Posts: 307
    Djinnie said:

    Information

    The graph would be useful information to have access to on this site.

    Djinnie

    Yes and no :-)

    Theres a lot of statistics out there regarding recurrence/mets, survival rates etc. None of them are false as such, but a lot are outdated, have limited statstical mass, poor data stratification etc.

    Some are of course overall applicable since they are not very detailed, like the recurrence risk model I posted further up, but the problem with posting any of them here permanently is, simply put; Who should judge which ones are the best to post?

    Also, having such data posted here un-commented, could mean that some members here take those statistics for immediately applicable to their own situation without asking around. I understand where your thought is coming from, but I think its better to post stuff like this "on request" and with comments and the possibility to debate it, like above.

    /G

     

  • Djinnie
    Djinnie Member Posts: 945
    Galrim said:

    Yes and no :-)

    Theres a lot of statistics out there regarding recurrence/mets, survival rates etc. None of them are false as such, but a lot are outdated, have limited statstical mass, poor data stratification etc.

    Some are of course overall applicable since they are not very detailed, like the recurrence risk model I posted further up, but the problem with posting any of them here permanently is, simply put; Who should judge which ones are the best to post?

    Also, having such data posted here un-commented, could mean that some members here take those statistics for immediately applicable to their own situation without asking around. I understand where your thought is coming from, but I think its better to post stuff like this "on request" and with comments and the possibility to debate it, like above.

    /G

     

    I see your point!
     
    Djinnie

    I see your point!

     

    Djinnie