Thanks a lot

@LewisHassell-OPEN

4 жыл бұрын

Most welcome

Thanks

How is it determined high grade serous vs high grade endometrioid? Solely based on the genetic mutations? I watched the whole video, and I do plan on emailing you. Thank you for posting this!

@LewisHassell-OPEN

2 жыл бұрын

Good question. In the endometrium, serous and clear cell carcinoma are by very definition high grade. There is no low grade endometrial serous cancer. In the ovary, that is not true, there are both high and low grade serous tumors, defined by both morphology, immunohistochemistry and molecular-genetic features. Endometrioid cancers are graded based on the proportion of solid growth (as opposed to open glandular growth) and so are defined by morphologic criteria. However, there is movement now to categorize endometrial tumors based on molecular groupings, which have some interesting surprises in terms of prognosis.

@katesnyder6415

2 жыл бұрын

@@LewisHassell-OPEN thank you Dr. Hassell. I emailed you last night (just realized I accidentally called you Dr. Lewis in my email - please forgive me!). I love this content, and I also joined your Facebook group. My mom was recently diagnosed with uterine cancer and her original biopsy showed high grade carcinoma favoring serous, but the pathology report from her surgery won’t be back for another few days.

@katesnyder6415

2 жыл бұрын

@@LewisHassell-OPEN my mom’s report came back and she’s stage 1A serous, no myometrial invasion, & no LVSI! 0.8 cm tumor

@LewisHassell-OPEN

2 жыл бұрын

@@katesnyder6415 that is certainly the best one could hope for at this point.

@katesnyder6415

2 жыл бұрын

@@LewisHassell-OPEN do people generally still do radiation and chemo for this? The national guidelines say observation as a possibility but obviously we know serous can be more aggressive?💕

What does high grade carcinoma with necrosis mean

@LewisHassell-OPEN

3 жыл бұрын

"Grading" refers to an assessment of agressiveness of a tumor, and to some degree how closely a tumor replicates normal tissue. High grade is usually worse for the patient than a low grade tumor, and may also refer to the kinds of treatments that may offer benefit. Necrosis is a term for dead tissue, or in this case, tumor tissue. It usually means the tumor is growing faster than the blood supply can keep up with.

Hi, My mother is diagnosed with this p53endometrial carcinoma,the report say: sections examined revealed multiple fragments of malignant neoplastic lesion which is composed of sheets of tumor cells which have large vasicular nuclei with prominent nuclei.focal areas of papplimoa are also seen. P53- diffusive strong positive wt-1- patchy positive p16-positive cytokeratin AE1/AE3 positive Er- patchy staining positive immunohistochemical favour serous carcinoma. Please tell wht stage nd what is the prognosis of it. and any suggestion Doctor

@LewisHassell-OPEN

3 жыл бұрын

Staging refers to the extent of disease-- how deeply invasive, whether or not it has spread to nodes or peritoneum, etc. Grade refers to the histologic severity and abnormality. Serous carcinoma is a high grade tumor, but staging, which is most closely related to prognosis, requires some combination of resection and intraoperative evaluation or radiologic study. So, I would think she could get those questions answered by further evaluation and possibly surgery if she is able to. And that will then guide the need for additional drugs or other treatment.

@CanadalifeVlogs468

3 жыл бұрын

@@LewisHassell-OPEN Thankyou Doc , is there any way to communicate with you for consultation? or else ill just post a reply here

@CanadalifeVlogs468

3 жыл бұрын

@@LewisHassell-OPEN can i share reports to u of her ultrasound

@CanadalifeVlogs468

3 жыл бұрын

@@LewisHassell-OPEN heru ct scan nd transvaginal ultrasound are already done, plz any guide would help alot, we are in alot of stress

@LewisHassell-OPEN

3 жыл бұрын

@@CanadalifeVlogs468 Yes, my email and Twitter handle are posted with each of the videos-- lewis-hassell@ouhsc.edu will reach me.

What if it's serous with only a small focus of mutant p53 and the rest wild-type?

@LewisHassell-OPEN

3 жыл бұрын

The high grade areas often drive behavior. Convention is to report mixed components greater than 10%, but minor components may be worth mentioning below that cut off. Serous carcinoma of the endometrium is defined by p53 mutation, but rare cases with wild type IHC staining are reported and only very rare tumors without detectable TP53 mutation.

@miowmiowmiow123

3 жыл бұрын

@@LewisHassell-OPEN Thank you for your response lewis! My mother has been diagnosed with stage 3c uterine cancer - histopathology report mentions that classification was difficult due to the largely wild-type p53 status of the tumour, along with other discrepancies. I was hoping it could be an endometrioid type mimicking serous, since prognosis would be much better in that case. Oncologist mentioned that a lower burden of p53 is good news - not sure how true that is. Any thoughts?

@miowmiowmiow123

3 жыл бұрын

Of note, all diseased lymph nodes, as well as the ovarian findings displayed wild-type p53.

@LewisHassell-OPEN

3 жыл бұрын

Since treatment regimens can be different based on the molecular phenotype, I would suggest two things- pathology review at a center doing high volumes of gyn tumors and molecular evaluation by NGS to evaluate for full mutation status. That should open up the best treatment options

@miowmiowmiow123

3 жыл бұрын

@@LewisHassell-OPEN Lewis do you mind if I email you to ask a couple more questions?