直腸癌 surgical margin

原貼01/2019

http://bbs.wenxuecity.com/health/820325.html

MRI: 

Mid rectal cancer (5 to 10 cm)., T3a N2. The anal sphincer is not involved. The circumferential resection margin is threatened by a mesorectal lymph node/tumor deposit. Findings suspicious for EMVI are present.

 

CT:

Several rounded and mildly enlarged lymph modes identified in the presacral space along the IMV chain raising the possibility of metastatic disease.

Primary rectal tumor is not appreciated on CT scan

No evidence for metastatic disease otherwise in the chest, abdomen or Pelvis.

 

五個cycle of  xeloda/oxaliplatin以後, now in the middle of xeloda/radiation

06/2019 MRI report

asymetric upper rectal wall thickening is again present but substantially decreased in thickness/bulk. The tumor extends for up to 3.5 cm in craniocaudad length now compared to 5.5 cm previsouly. The lower margin of the mass terminates approximately 4.5cm cephalad to the anal sphincter. Previously seen minimal invasion into the perirectal fat left of midline appears improved. There is no necrosis. 

No pelvic free fluid is seen. The bladder appears unremarkable. Previously seen enlarged lower IMA chain/perirectal/presacral lymph nodes have resolved.

不知道surgical margin 在放療以後會不會更好一點, 現在4.5cm風險大不大? 多謝

 

所有跟帖： 

• 看你以前的貼，你應該蠻年輕的，祝早日康複。希望有懂的網友來回答你 -awr- ♀ (0 bytes) () 07/04/2019 postreply 05:05:32

• 同祝福。也許試試美國的幾個著名的治療中心找第二意見？ -SleepyLagoon- ♀ (92 bytes) () 07/04/2019 postreply 11:34:26