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My Mother Recently Had A Rectal Cancer Surgery (stage III).

Posted on Tue, 19 Jan 2021

Question: My mother recently had a rectal cancer surgery (stage III). Everything went well with negative margins (even though she had some postive limph nodes, the CEA levels are almost at 0, the same for CA 19 and the tumor grade is =1, negative perinerual and limphovascular invasion and no tumoral deposits found). She has now a temporal ilestomy that should be reverted in February. In the 1st scanner she did after the surgery (2 months after) everything looked good except for adenopathy in the left iliac chain of 16mm x 12mm which worries me. The doctor said we have to follow it up. She had some infection in the internal wound after surgery and at the time of the scanner she still had pain the rectum zone. Do you think this limph node size should be considered a metastasis? or maybe it could be due to the surgery inflammation. Thanks!

Answered by Dr. Dr.Dorina Gurabardhi (1 hour later)

Brief Answer:
A biopsy of the lymph nodes is required for further evaluation.

Detailed Answer:
Hello dear and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

The swollen lymph nodes often occur after an infection.
You mentioned in the query that your mother had an infection in the internal wound.
This can be the cause of the swollen lymph nodes.
It is important to follow up after three months for further evaluation.
A biopsy may be required to examine the lymph node tissue.

Hope I have answered your query. Let me know if I can assist you further.

Kind regards!

Dr.Dorina Gurabardhi
General &Family Physician

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr.Dorina Gurabardhi (2 hours later)

Thank you very much! Can I ask you what the recurrence risk is for her facts? Stage 3, 8 over 13 postive limph nodes CEA levels are almost at 0, the same for CA 19 and the tumor grade is =1, negative perinerual and limphovascular invasion and no tumoral deposits found.
She had 25 sessions of radiotherpy, 1 week of continuinng 5-FU quimo and capacetabine from february to may until she finished the radiotherapy. Everythingbefore the surgery. The tumor size was 5cm and there were 3 cm of free margins after surgery.

Thanks!

Answered by Dr. Dr.Dorina Gurabardhi (12 hours later)

Brief Answer:
There is a risk of recurrence.

Detailed Answer:
Hi again dear,

There is a risk of recurrence.
The recurrence depends on the effectiveness of radiotherapy and chemotherapy.
It is very important to follow up with your doctor every three or six months to maintain the situation under control.
I also recommend doing the biopsy of the lymph nodes for further evaluation.

Hope it helps dear,
Dr.Dorina Gurabardhi

Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Nagamani Ng