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Post Surgery Pathology Report
Hello Heroes, got my post surgery pathology report, it seems very positive, take a look below, all lymph nodes are clear, staging T3, N0, M0. I am only concerned about this “Microscopic tumor extension: Tumor invades adventitia and/or perigastric adipose tissue” However, if the margins are clear it should really matter, does anyone have any opinion?? I think absence of lymph node involvement is way more important???
1. Lymph node, mediastinum level Eight; excision:
- One benign lymph node (0/1).
2. Esophagus and Stomach; Esophagogastrectomy(Freeze proximal and distal margin); Excision/Resection:
Procedure: Esophagogastrectomy
Histologic tumor type: Adenocarcinoma
Lauren classification of adenocarcinoma: (For Siewert type-II and Siewert Type-III only): Mixed (approximately equal amounts of intestinal and diffuse)
Alternative adenocarcinoma classification (based on WHO) (For Siewert type-II and Siewert Type-III only): Poorly cohesive carcinoma signet ring cell type
Treatment effect: Present, involving 40% of the tumor
Residual cancer showing evidence of tumor regression, but more than single cells or rare small groups of cancer cells (partial response, score 2)
Histologic grade: Poorly differentiated
Tumor site: Lower thoracic esophagus (< 5 cm above GEJ), extends 50% into the stomach (epicenter >2 cm in the esophagus)
Siewert type: (relationship of tumor to GEJ): Type II (< 75% above GEJ or < into the stomach)
Size of tumor: Greatest dimension 10 cm
Microscopic tumor extension: Tumor invades adventitia and/or perigastric adipose tissue
Lymphovascular invasion: Not identified
Perineural invasion: Not identified
Tumor multicentricity: Not identified
Additional pathologic findings:
Unremarkable squamous mucosa
Unremarkable gastric mucosa
Unremarkable columnar mucosa
Margins (when all margins are free):
All surgical margins uninvolved by invasive carcinoma
Lymph nodes:
No applicable (no regional nodes submitted or found)
Number of lymph nodes with metastasis in this specimen: 0
Number of lymph nodes examined in this specimen: 33
Periesophageal: 6
Pericardial: 6
Lesser curve: 3
Left gastric artery: 18
Number of lymph nodes with metastasis in all specimen: 0
Number of lymph nodes examined in all specimen: 59
TNM descriptors: y (posttreatment)
Primary tumor (pT) (AJCC 8th edition): pT3: Tumor invades adventitia
Regional lymph nodes (pN) (AJCC 8th edition): pN0: No regional lymph node metastasis
3. Lymph node, hepatic artery; excision:
- Four benign lymph nodes (0/4).
4. Lymph node, splenic artery; excision:
- Benign fibroadipose tissue.
5. Lymph node, level Seven; excision:
- Sixteen benign lymph nodes (0/16).
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Hello!
I fed that bit of you report into chatGPT this is what it reported:
Tumor invades adventitia and/or perigastric adipose tissue
Adventitia:
This is the outermost layer of tissue surrounding organs like the stomach or esophagus.
If a tumor reaches the adventitia, it means it has penetrated all the way through the wall of the organ.
Perigastric adipose tissue:
This is the fat tissue that surrounds the stomach.
If tumor cells are found here, it means the cancer has spread into the fatty tissue around the stomach.
🧾 What this usually means:
The cancer is not confined to just the lining or wall of the stomach or esophagus—it has invaded nearby tissues, which may indicate a more advanced stage.
This kind of invasion is often consistent with T3 or T4 in TNM staging (Tumor, Node, Metastasis), depending on the exact structures involved.
🩺 Why it matters:
The extent of tumor invasion helps determine the stage of cancer.
This staging helps doctors decide the best treatment options (surgery, chemo, radiation) and gives some idea about prognosis.
Never rely on ChatGPT for something like this. I am classified as stage IIB based on the pathology of T3, N0, M0. The report also states the tumor has invaded the Adventia, not penetrated it and my surgeon also told me when I was in the hospital that there was no breach of the wall. It’s just I already spoke to experts before you responded. My advise, never reply on ChatGPT for cancer advice, it’s full of disinformation.