I'm gonna cry.
Vicky's results came back.
Could be worse. But definitely could be better.
The cancer is stage III.
Stage III (23% of patients);
For Stage III Wilms' tumor, 1 or more of the following criteria must be met:
Unresectable primary tumor.
Lymph node metastasis.
Positive surgical margins.
Tumor spillage involving peritoneal surfaces either before or during surgery, or transected tumor thrombus.
Treatment: Abdominal radiation + 24 weeks of chemotherapy + nephrectomy after tumor shrinkage
Outcome: 95% 4-year survival; 56% 4-year survival if anaplastic.
[It's stage III because of lymphnode metastasis, and she sure won't need another nephrectomy because she only has one kidney left and the tumor itself is gone.]
We don't know if it's anaplastic or not yet. We obviously don't want it to be, seeing as there's nearly a 40% better chance of her surviving if it's not anaplastic.
Here's the low-down on anaplasia;
Children with stage I anaplastic tumors have an excellent prognosis (80-90% five-year survival). They can be managed with the same regimen given to stage I favorable histology patients.
Children with stage II through stage IV diffuse anaplasia, however, represent a higher-risk group. These tumors are more resistant to the chemotherapy traditionally used in children with Wilms’ tumor, and require more aggressive regimens.
Anaplasia refers to undifferentiated cell growth in a malignant neoplasms (tumors). Lack of differentiation is considered a hallmark of malignancy. The term anaplasia literally means "to form backward." It implies dedifferentiation, or loss of structural and functional differentiation of normal cells. It is now known, however, that at least some cancers arise from stem cells in tissues; in these tumors failure of differentiation, rather than dedifferentiation of specialized cells, account for undifferentiated tumors.
Anaplastic cells display marked pleomorphism. The nuclei are characteristically extremely hyperchromatic (darkly stained) and large. The nuclear-to-cytoplasmic ratio may approach 1:1 instead of the normal 1:4 or 1:6. Giant cells that are considerably larger than their neighbors may be formed and possess either one enormous nucleus or several nuclei. Anaplastic nuclei are variable and bizarre in size and shape. The chromatin is coarse and clumped, and nucleoli may be of astounding size. More important, mitoses are often numerous and distinctly atypical; anarchic multiple spindles may be seen and sometimes appear as tripolar or quadripolar forms. Also, anaplastic cells usually fail to develop recognizable patterns of orientation to one another (i.e. they lose normal polarity). They may grow in sheets, with total loss of communal structures, such as gland formation or stratified squamous architecture. Anaplasia is the most extreme disturbance in cell growth encountered in the spectrum of cellular proliferations.
Uncle Mike asked that we don't visit Victoria until she's home.
I miss my baby.
Could be worse. But definitely could be better.
The cancer is stage III.
Stage III (23% of patients);
For Stage III Wilms' tumor, 1 or more of the following criteria must be met:
Unresectable primary tumor.
Lymph node metastasis.
Positive surgical margins.
Tumor spillage involving peritoneal surfaces either before or during surgery, or transected tumor thrombus.
Treatment: Abdominal radiation + 24 weeks of chemotherapy + nephrectomy after tumor shrinkage
Outcome: 95% 4-year survival; 56% 4-year survival if anaplastic.
[It's stage III because of lymphnode metastasis, and she sure won't need another nephrectomy because she only has one kidney left and the tumor itself is gone.]
We don't know if it's anaplastic or not yet. We obviously don't want it to be, seeing as there's nearly a 40% better chance of her surviving if it's not anaplastic.
Here's the low-down on anaplasia;
Children with stage I anaplastic tumors have an excellent prognosis (80-90% five-year survival). They can be managed with the same regimen given to stage I favorable histology patients.
Children with stage II through stage IV diffuse anaplasia, however, represent a higher-risk group. These tumors are more resistant to the chemotherapy traditionally used in children with Wilms’ tumor, and require more aggressive regimens.
Anaplasia refers to undifferentiated cell growth in a malignant neoplasms (tumors). Lack of differentiation is considered a hallmark of malignancy. The term anaplasia literally means "to form backward." It implies dedifferentiation, or loss of structural and functional differentiation of normal cells. It is now known, however, that at least some cancers arise from stem cells in tissues; in these tumors failure of differentiation, rather than dedifferentiation of specialized cells, account for undifferentiated tumors.
Anaplastic cells display marked pleomorphism. The nuclei are characteristically extremely hyperchromatic (darkly stained) and large. The nuclear-to-cytoplasmic ratio may approach 1:1 instead of the normal 1:4 or 1:6. Giant cells that are considerably larger than their neighbors may be formed and possess either one enormous nucleus or several nuclei. Anaplastic nuclei are variable and bizarre in size and shape. The chromatin is coarse and clumped, and nucleoli may be of astounding size. More important, mitoses are often numerous and distinctly atypical; anarchic multiple spindles may be seen and sometimes appear as tripolar or quadripolar forms. Also, anaplastic cells usually fail to develop recognizable patterns of orientation to one another (i.e. they lose normal polarity). They may grow in sheets, with total loss of communal structures, such as gland formation or stratified squamous architecture. Anaplasia is the most extreme disturbance in cell growth encountered in the spectrum of cellular proliferations.
Uncle Mike asked that we don't visit Victoria until she's home.
I miss my baby.