Pathology Lab result interpretation

My mom is recently diagnosed with ovarian cancer. On the pathology letter mentioned:

-Bilateral ovarian adenocarcinoma
-Papillary serous systic type
-moderately differentiated
-vascular invasion: identifed
-perineural invasion: dentified
-endometrium: inactive
-tubes: tumor free
-staging: T1C ( tumor is seen in both ovaries with involvement of ovarian surface and omental seeding)

C 56.9
M=8460/3

She went through a debulking surgery 2 months ago. She had cabo/taxol 3 weeks ago. second dose this Tuesday and she has to complete 6 doses in every 21 days.

Questions:
1. If there is omental seeding then doesn't it make the staging 3? Is there a possibility of mistaken staging? If so what is the correct staging? How does it impact the chemotherapy treatment?
2. How serious can be the terminology vascular and perineural invasion identified? Does it mean the cancer has already spread to other organs?
3. How agressive and invasive this type of cancer is? What prognosis and survival rate is for this patient?
4. What does mean C 56.9   M=8460/3  ?

Many thanks in advace for your replies

[Annekathryn Goodman, M.D.]

Hi There
thank you for your complete information.
I am not sure what those numbers mean. (C and M) you should ask the doctor what particular form it comes from

I agree that omental involvement categorizes your mother's cancer as a stage III

prognosis will vary on the sensitivity the cells have to being killed by chemo.
this website is fairly reasonable
http://www.ehow.com/about_5251414_stage-ovarian-cancer_.html

If she is having trouble with her white blood cell count, you should ask her doctor about other options such as giving a lower dose once a week

I consider something like the following in my patients:

weekly carboplatin AUC 2 with weekly taxol AUC 60-80mg/m2
or

carboplatin alone AUC 4-6 once every 3 weeks

or even completely changing drugs to carboplatin and doxil

I know this is very stressful for everyone
'best wishes

[halber30]

Just to add some more information about the Pathology result.

her surgery was TAH+BSO+ partial omentectomy

Macroscopic:
Omental tissue is yellowish and in serial cut sections is hemorrhagic with foci of rather firm consistency.
Microscopic: The omentum shows metastatic foci

Diagnoses:
Cervix: chronic cervicitis
Myometrium: one intra mural leiomyoma

[halber30]

Another information to add: her CA 125 test prior to surgery was 70.
In her Pathology after surgery:

Macroscopic: Left ovary is ovoid creamy yellow with nodular surface, measuring 7x5x3.5cm.in serial cut sections is partially cystic.The solid component is yellowish and soft with smooth internal surface. the right ovary 3.5x3x2.5 with the same colour and cystic characteristic of left ovary.
Microscopic:
Sections of both ovaries show involvement by a malignant tumor of glandular origin. The tumor celis have pleomorphic nuclei and eosinophilic cytoplasm forming large glandular spaces with many papillary projections. The endometrium is inactive.

Sorry to add information every couple of hours, I'm really worried about my mom and need your opinion about the accurate stage of her illness and the chances of beating cancer. She is my best friend and I love her very much.

Many thanks in advance for your reply

[halber30]

Hello Dr. Goodman;

My mom went this morning for the second chemo and they sent her home because her WBC was 2500. She has to have 3 shots of neupogen before she goes back again for another blood test and hopefully chemo.
My question is, after her first chemo she received 5 shots of neupogen within 72 hours of chemo, so why her WBC is still that low?
Is there any risk that she won't be able to continue chemo?
In that case what will be the alternatives?
P.S. Her WBC was always abnormally low for years. Prior to first chemotherapy her WBC was 3400 and she received 5 shots before starting the first chemo that took the WBC up to 7000. Also she had another 5 shots of Neupogen after the first chemo.

[halber30]

Hi Dr Goodman;

Since the 6th of Feb, I'm waiting your reply regarding my mum's condition. I saw you replied some of the questions that were posted later on 13th and 14th but me and some other people are still waiting your answer.

I know that you must be very busy and I appreciate a lot your time and replies on this website. I just wanted to make sure that you did not forgot the questions posted earlier.

Thanks a lot